Provider Network Configuration Specialist
About The Position
Under direct supervision, work within and across department teams to maintain the configuration of providers, locations, groups, plans, and benefit limits in the managing system. Ensure accurate and timely completion of production tickets assigned to ensure client satisfaction and retention. Support provider management activities associated with provider data maintenance, credentialing activities, directory management, and intake requests. Essential Functions Research, resolve, document, and accurately respond to provider, practice, business partner, or administrator inquiries and service requests. Communicate and coordinate with providers, practices, and other departments to ensure accurate information is available to support business needs. Add and update Benefits Limits, Groups, Plans, new providers, and new locations in the system. Upload fee schedules. Responsible for the accurate setup of direct deposits. Configure and provide appropriate web portal access to clients. Timely and accurately generate and deliver reports as requested. Responsible for new business configuration setups following established processes/protocols. Ensure requested information is delivered within the specified timeframe and completed accurately. Maintain high standards in all written or verbal communications with providers.
Requirements
- Two years of experience in health insurance information and data management systems.
- Strong understanding of health plan terminology.
- Computer proficiency, including Microsoft Excel and other MS Office tools.
- Strong analytical and critical thinking skills.
- Ability to read and write at a level necessary to accomplish the above tasks.
- Demonstrated ability to identify problems and provide creative solutions.
- Strong attention to detail, organizational skills, and problem-solving skills.
- Highly motivated and reliable individual with a strong sense of urgency; ability to meet tight deadlines.
- Excellent written and verbal communication skills.
- Ability to work independently and in a team environment.
Responsibilities
- Maintain the configuration of providers, locations, groups, plans, and benefit limits in the managing system.
- Ensure accurate and timely completion of production tickets assigned to ensure client satisfaction and retention.
- Support provider management activities associated with provider data maintenance, credentialing activities, directory management, and intake requests.
- Research, resolve, document, and accurately respond to provider, practice, business partner, or administrator inquiries and service requests.
- Communicate and coordinate with providers, practices, and other departments to ensure accurate information is available to support business needs.
- Add and update Benefits Limits, Groups, Plans, new providers, and new locations in the system.
- Upload fee schedules.
- Responsible for the accurate setup of direct deposits.
- Configure and provide appropriate web portal access to clients.
- Timely and accurately generate and deliver reports as requested.
- Responsible for new business configuration setups following established processes/protocols.
- Ensure requested information is delivered within the specified timeframe and completed accurately.
- Maintain high standards in all written or verbal communications with providers.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
