Provider Coordinator

Job Description:
Will these roles be fully remote? Yes
Are there any specific locations the candidates should be in? No
(Client, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI)
What is the expected schedule (include dates/time) M-F, 8-5 with some flexibility on this. Could be 7-4, or 9-6, or variations of this.
What are the day to day job duties?
Temp help for Provider Network Administration team intake of emails, logging of emails, submissions of provider rosters to PDM, etc.
Top Skills Required:
Organization; Excel proficiency (although no need for SME); data entry; attention to detail; understanding of provider data (NPIs, service locations, state registration files, etc)

Required Education/Certification(s): No specific requirements

Required Years of Experience: 2+ years in some kind of provider data role is preferred

Summary:
This position is responsible for accurately entering provider demographic and contract affiliation information into the health plan system. Must be able to accurately interpret request and enter into the system in such a way that all data is correct and claims adjudication is optimized.

Essential Functions:
Receive information from outside party(ies) for update of information in computer system(s).
Analyze by applying knowledge and experience to ensure appropriate information has been provided.
Load and maintain provider information into computer system(s) with attention to detail and accuracy in a timely manner to meet department standards of turnaround time and quality. Audit loaded provider records for quality and financial accuracy and provide documented feedback.
Assist in system/health plan integration. Train current staff and new hires as necessary.
Assist in system related testing.

Knowledge/Skills/Abilities:
Excellent attention to detail Ability to enter information in a timely manner Good project management skills Able to meet deadlines and time constraints Strong knowledge of Microsoft office including Outlook, Word, Excel, and Access
Ability to lean internal systems QNXT Excellent verbal and written communication skills Ability to abide by Clients policies
Maintain regular attendance based on agreed-upon schedule Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education: High School Diploma or equivalent GED

Required Experience: 0-2+ years managed care experience