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Specialist, Provider Network Administration
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Job Description
- Req#: 300001357899275
Employer Industry: Healthcare Provider Network Administration
Why consider this job opportunity:
- Competitive benefits and compensation package
- Opportunity for career advancement and growth within the organization
- Engaging work environment with opportunities to participate in special projects
- Supportive team atmosphere with training for both current staff and new hires
- Chance to impact provider network management and data accuracy
What to Expect (Job Responsibilities):
- Oversee the receipt and coordination of provider network data for entry into the provider management system
- Review and analyze data to ensure accuracy and appropriateness of information provided
- Audit loaded provider records for quality and financial accuracy, providing documented feedback
- Assist in configuration issues and collaborate with Corporate team members
- Conduct provider data audits and work on ad hoc projects as needed
What is Required (Qualifications):
- Associate degree in Business or equivalent combination of education and experience
- Minimum of 3 years of managed care experience
- Experience in claims processing, provider services, or provider network operations
- Proficiency in MS Excel (intermediate level - Vlookups, Pivot tables, graphs, reports)
- Familiarity with Salesforce and QNXT is highly preferred
How to Stand Out (Preferred Qualifications):
- Bachelor's degree
- Over 3 years of experience in provider claims and/or provider network administration
- Knowledge of medical terminology, CPT, ICD-9 codes, etc.
- Intermediate or higher skill level in Access and Excel
#Healthcare #ProviderNetwork #ManagedCare #DataAccuracy #CareerGrowth
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