Provider Administration Coordinator

Blue Cross & Blue Shield of Mississippi • Flowood, MS

2d

About The Position

The Provider Administration Coordinator is essential in maintaining complete and accurate provider contracting documentation and directory information to meet the service needs of our customers and Network Providers. The Provider Administration Coordinator is responsible for provider administrative activities to include, ownership and maintenance of all Network Provider Contract inventories and contract templates. This position is also accountable to perform bi-annual validation and verification of provider contract completeness against provider reimbursement schedules and maintenance of relational Network Provider profiles, to include provider location changes. The Provider Administration Coordinator will serve as a resource to publish GeoAccess reports to support Network Access requests and SAS reports to support the Provider Information Group with claim activity and claim adjustment requests. The position will also be responsible for facilitation of all provider contract changes, to include provider manuals, contract updates, etc. The Provider Administration Coordinator is also responsible for coordinating and facilitating all provider related mail-outs. This position is accountable to ensure the integrity and accuracy of the Provider Network Directories by conducting a review of all provider categories and provider specialties published in the online directory. The Provider Administration Coordinator is responsible for credentialing activities related to Disease Specific Pharmacy providers. This position is also accountable to serve as back-up to the Provider Service Specialist to ensure timely and accurate response to provider inquiries.

Requirements

• A Bachelor’s degree in a business related field is required.
• Must have 2 years’ experience in provider networks or provider office administration or two years' customer service experience with BCBSMS.
• Must have strong diplomatic, conflict resolution and negotiating skills.
• Must have excellent analysis and issue resolution skills.
• Must have excellent business writing skills.
• Must have an excellent understanding of healthcare provider office management and business processes.
• Must have strong communication skills.
• Must have an excellent understanding of healthcare benefits and network products.
• Personal Computer skills required to include the Microsoft Office suite.

Responsibilities

• Ownership and maintenance of all Network Provider Contract inventories and contract templates.
• Perform bi-annual validation and verification of provider contract completeness against provider reimbursement schedules.
• Maintenance of relational Network Provider profiles, to include provider location changes.
• Publish GeoAccess reports to support Network Access requests.
• Publish SAS reports to support the Provider Information Group with claim activity and claim adjustment requests.
• Facilitation of all provider contract changes, to include provider manuals, contract updates, etc.
• Coordination and facilitation of all provider related mail-outs.
• Ensure the integrity and accuracy of the Provider Network Directories by conducting a review of all provider categories and provider specialties published in the online directory.
• Credentialing activities related to Disease Specific Pharmacy providers.
• Serve as back-up to the Provider Service Specialist to ensure timely and accurate response to provider inquiries.

Benefits

• A comprehensive benefits package that is worth approximately one-third of the salary compensation.
• Our benefits program is among the best in the health care field.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level