Job Description
Job Description Below:-
Role: Healthcare Provider Data Analyst
Location: Work From Home -candidates in either California or the same time zone as the facility. Torrance, CA
Assignment: 6-month assignment to start and possible ext. or perm, but based on company needs and performance/evaluation
Shift: M-F
- Overview:
- The Network Operations Coordinator 2 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 2 performs varied activities and moderately complex administrative/operational/customer support assignments.
- Performs computations.
- Typically works on semi-routine assignments.
- The Network Operations Coordinator 2 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 manages provider-perceived service failures.
- Decisions are typically focused on the interpretation of the area/department policy and methods for completing assignments.
- Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
- Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
- Required Qualifications
- Less than 3 years of technical experience
- Proficiency in MS Office applications
- Possesses a strong attention to detail
- Ability to work in a deadline-driven environment
- Strong verbal and written communication skills
- Previous account management, project management, or related experience
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Preferred Qualifications
- Associates' or Bachelor's Degree
- Prior experience working in the insurance industry
- Proficiency in MS Access
- Previous experience in claims
- Prior contract interpretation experience strongly desired
- Previous provider experience (provider contract, provider relations, or provider service)
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