Note: The job is a remote job and is open to candidates in USA. The client is a leading insurance company. The Provider Administrator manages provider and office staff service requests, supports provider data maintenance and credentialing activities, resolves inquiries, coordinates with internal and external teams, and maintains accurate provider information across systems.
Responsibilities
- Under direct supervision, work within and across department teams to manage provider and office staff service requests, resolve business partner questions/issues and provide call handling/routing to provider support line
- Support provider management activities associated with provider data maintenance, credentialing activities, directory management and intake requests
- Research, resolve, document and accurately respond to provider, practice, business parter or administor inquires and service requests
- Communicate and coordinate with providers, practices and other departments to ensure accurate information is available to support business needs
- Manage the Committee meetings set up, document Committee findings in the formal meeting minutes and notify staff of Committee decisions
- Monitor and maintain critical provider information in various systems
- Review team member quality assurance reports on a regular basis and working with leadership to prepare follow-up documentation
- Act as first-level intake and triage for incoming provider call line, data clean-up efforts and specified team email box requests. Support the client and regulatory audit process to include pulling required documentation and review of provider files for accuracy
- Gain industry knowledge to support internal and external business partner relationships. Support the recredentialing process and audit support functions to NCQA and client standards
- Ensure requested information is delivered within specified timeframe and completed accurately. Maintain high standards in all written or verbal communications with providers
Skills
- Remote - Flex but available between 6 am PST to 5pm PST
- Must have Salesforce and excel experience, strong attention to detail, and be able to communicate and collaborate with teams
- Salesforce
- Sharepoint
- Two to four years of general office experience
- Proficient with word and spreadsheet applications
- Ability to read and write at a level necessary to accomplish the above tasks
- Demonstrated ability to identify problems and provide creative solutions
- Strong attention to detail, organizational skills and problem solving skills Excellent written and verbal communication skills Ability to work independently and in a team environment
- For roles that are remote (i.e., Work From Home (WFM)) or hybrid (i.e., partial onsite at a Client location and WFM), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment
- Microsoft Teams
Benefits
- ACA compliant medical coverage to all employees
- Dental insurance to all employees
- Vision insurance to all employees
- Sick time benefits as required per State regulations
- Remote role
Company Overview