Job Description

 

Job Description

The primary purpose of the job is to:
Responsible for addressing provider issues and maintaining the provider tracking databases. In addition, the Network Coordinator supports the Network Management Department by assisting with root cause analysis and/or the development of reports, and other support activities related to monitoring the accuracy of provider contract configuration and resolution of provider issues.

•Serves as a resource to Network Management Account Executives for contracting and provider set up questions/issues.

•Assists the Contract Management Coordinator as necessary to assess issues/problems being encountered by providers and staff.

•Responsible for Provider demographic management which includes additions, deletions or corrections and initial provider loads to Provider Maintenance.

•Responsible for panel adds, holds and changes, member reassignments and member interventions as requested from Providers as mandated by State.

•Responsible for the PMP/PCP Add and Terms with the State, as mandated by State. •Responsible for updating the provider contract database with new information or modifications to existing provider contracts accurately and within established timeframes.

 

Skills:
  

 

Minimum 1
– 2 years experience in member, provider and/or finance operations in a healthcare or Managed Care Organization

•1-2 years experience in customer service

•1-2 years business analyst experience preferred.

•1-2 years Medicaid experience preferred •Proficiency with Microsoft Office Suite (Word, Excel, Power Point).

•Access is a plus.

•Consistent word processing speed and accuracy of 50 or more words per minute.

 

Education:
      

Associate Degree or equivalent combination or education and work experience in a Health Care Field preferred.      

 

 

 

Company Description

Della Infotech Inc is in staffing business for five years. Over the years, we have placed hundreds of candidates to various temp and permanent positions with our 50+ happy clients all over US and Canada including Fortune 500 corporations.

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