Provider Network Operations Coordinator 4- WAH MO KS WI OK

Profile

Description

The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider data needed for service operations. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

The Network Operations Coordinator 4 manages and maintains provider contract data and demographics for assigned provider groups for the Health Plan. Manages provider relationships through shared services that supports Provider Network Operations. This is includes, but is not limited to:


Performing Roster Audits
Acting as a customer service liaison
Resolving provider load issues
Managing Projects as assigned


Makes decisions regarding own work methods, and requires minimal direction. Uses critical thinking to solve problems, works independently with strong time management and organizational skills to complete required work. Follows established guidelines and procedures. All other duties as assigned.

Required Qualifications


2 years of provider relations experience, administrative/office management or related Health Care services experience
Intermediate in Microsoft Word and Excel
Prior experience managing mid to large scale projects


Preferred Qualifications


Provider contract interpretation experience
Previous account management or project management
Knowledge with medical claims


Additional Information

Scheduled Weekly Hours

40

Company info

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