About The Position

Become a part of our caring community and help us put health first The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. You will report to the Supervisor, Network Operations. As the Network Operations Coordinator 3, you will: Manage data for health plans including demographics, rates, and contract intent. Manage provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Use your skills to make an impact

Requirements

  • 2 or more years of experience working in a healthcare setting
  • Proficient in Microsoft Excel (ie formulas, filter, sort)
  • 1 or more years' Experience with in person or telephonic customer service skills

Nice To Haves

  • Experience with providers, payors, healthcare facilities, etc
  • Experience in Healthcare claims
  • Prior contract interpretation experience
  • Provider credentialling experience
  • Data analytic experience
  • Intermediate experience with Excel (pivot tables, formatting, v-lookup)

Responsibilities

  • Manage data for health plans including demographics, rates, and contract intent.
  • Manage provider audits, provider service and relations, credentialing, and contract management systems.
  • Executes processes for intake and manage provider perceived service failures.

Benefits

  • Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
  • Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
  • Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

No Education Listed

Number of Employees

5,001-10,000 employees

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