Note: The job is a remote job and is open to candidates in USA. Humana is a healthcare company providing insurance and healthcare services. The Network Operations Coordinator 3 manages provider data for health plans and oversees provider audits, service and relations, credentialing, and contract management systems. The role also handles provider service failures and administrative processes.
Responsibilities
- The Network Operations Coordinator 3 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 typically focus on methods, tactics and processes for completing administrative tasks/projects
- Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge
Skills
- Minimum of 2 years of experience working in a healthcare setting with providers, payors, healthcare facilities, etc
- Data analytic experience
- Intermediate skills with Microsoft Office, and proficient in Excel
- Ability to multi-task and work in a deadline driven environment
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- While this is a remote position, occasional travel to Humana's offices for training or meetings may be required
- Provider credentialling experience
- Previous experience in claims
- Prior contract review, loading or interpretation experience
Benefits
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Remote work arrangement
Company Overview
Company H1B Sponsorship