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Network Operations Coordinator 4

Company: Humana
Location: Green Bay
Posted on: September 9, 2019

Job Description:

DescriptionThe 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.ResponsibilitiesThe 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 or equivalent
  • 2 + years of provider relations experience
  • Intermediate skills in Microsoft Word and ExcelPreferred Qualifications
    • Provider contract interpretation experience
    • Previous account management or project management
    • Knowledge with medical claims
    • Valid drivers license and reliable transportationAdditional InformationScheduled Weekly Hours40

Keywords: Humana, Green Bay , Network Operations Coordinator 4, Other , Green Bay, Wisconsin

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