Network Operations Coordinator 4
Humana

Roswell, Georgia

Posted in Insurance


This job has expired.

Job Info


Description

The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

How we Value You
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for well-being

Responsibilities

The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with little oversight.

Required Qualifications

  • High School Diploma
  • 2 or more years of provider relations experience
  • Healthcare Industry experience
  • Credentialing process experience
  • Intermediate in Microsoft Word and Excel
  • Strong Attention to detail and follow-up
  • Work at home (WAH) requirements include a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
  • Bachelor's Degree
  • Provider contract interpretation experience
  • Previous account management or project management
  • Knowledge with medical claims
Additional Information

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website

If you are an Internal Candidate and you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Scheduled Weekly Hours

40


This job has expired.

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