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Specialist, Provider Network Administration (FL Healthplan - EST hours)
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Job Description
- Req#: 300002092627525
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Supportive and collaborative work environment
- Chance to make a positive impact on provider network operations
- Work within a dynamic team focused on healthcare excellence
What to Expect (Job Responsibilities):
- Validate and maintain critical provider information in claims and provider databases
- Review and analyze data to ensure appropriate information is provided
- Maintain quality standards for provider demographic data and fee schedules
- Audit provider records for quality and financial accuracy, providing documented feedback
- Assist in resolving configuration issues with relevant teams
What is Required (Qualifications):
- At least 3 years of healthcare experience, including claims, provider services, or provider network operations
- Claims processing experience, including coordination of benefits and eligibility criteria
- Strong attention to detail with the ability to facilitate accurate data entry/review
- Customer service skills and the ability to manage multiple priorities
- Proficiency in Microsoft Office suite and applicable software programs
How to Stand Out (Preferred Qualifications):
- Experience with medical terminology, CPT, and ICD-9/ICD-10 codes
- Intermediate skills in Microsoft Excel
#HealthcareServices #ProviderNetwork #CareerOpportunity #CompetitivePay #AttentionToDetail
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