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Network Operations Coordinator 3 - Jackson Mississippi
Company: Humana Location: Jackson, Mississippi
Posted On: 05/18/2024
Become a part of our caring community and help us put health first The Network Operations Coordinator 3 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 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. The Network Operations Coordinator 3 manages provider data 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. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: -
Health benefits effective day 1 -
Paid time off, holidays, volunteer time and jury duty pay -
Recognition pay -
401(k) retirement savings plan with employer match -
Tuition assistance -
Scholarships for eligible dependents -
Parental and caregiver leave -
Employee charity matching program -
Network Resource Groups (NRGs) -
Career development opportunities #LI-Remote #LI-JR1 Use your skills to make an impact Required Qualifications -
2 or more years of prior experience in an administrative or customer support role within the health insurance industry -
Intermediate skills with Microsoft Word and Excel to include vlookups -
Ability to work in a deadline driven environment Preferred Qualifications -
Previous experience in claims -
Prior contract interpretation experience -
Knowledge of Humana systems (APEX, PMDM, PAAG) Additional Information This role is considered "remote/work at home" and can be based anywhere in the United States with the ideal candidate being located in the Eastern Time Zone. Work at Home Information To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: |
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