Specialist, Provider Network Admin - Remote

Overview

The Provider Network Administration role is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases, ensuring adherence to business and system requirements.

In Short

• Coordinate data from the provider network for entry into the provider management system.
• Review and analyze data for accuracy.
• Audit provider records for quality and financial accuracy.
• Assist in configuration issues with Corporate team members.
• Train current staff and new hires.
• Participate in special projects as requested.
• Requires an Associate degree in Business or equivalent experience.
• Minimum 3 years of managed care experience required.
• Experience in claims processing and provider network operations preferred.
• Intermediate skills in Access and Excel are preferred.

Requirements

• Associate degree in Business or equivalent experience.
• Minimum 3 years managed care experience.
• Experience in Claims, Provider Services, or similar fields.
• Claims processing background including coordination of benefits.
• 3+ years of Provider Claims or Network Administration experience preferred.
• Knowledge of Medical Terminology, CPT, ICD-9 codes.
• Intermediate skills in Access and Excel.

Benefits

• Competitive benefits and compensation package.
• Equal Opportunity Employer (EOE).