Provider Operations Coordinator, Sr

Supports the Provider Relations Field Representative to achieve department goals. Answer incoming telephone inquiries from providers and assist with problem resolution of issues. Perform Excel data analysis. Process incoming mail. Coordinate submission of provider contract records to internal departments.
Essential Functions:
  • Supports the Provider Relations Field Representative to achieve department goals and resolve claims and payment issues.
  • Answers incoming telephone inquiries from providers and assists with problem resolution of issues.
  • Root cause analysis of operational and health services issues.
  • Reviews and processes incoming and outgoing paperwork, including directory updates, provider credentialing applications, Contract Maintenance forms and other related forms.
  • Tracks new contracts through sidewinder.
  • Audits configuration loads on new contracts.
  • Provides office, project management, provider recruitment and data analysis support.
  • Special projects as assigned or directed.
Education: Associate's degree preferred
Experience: 3 years experience in customer service or claims with exposure to problem resolution
Special Skills (e.g. 2nd language): Excellent problem solving skills. Excellent oral and written communication skills. Must be organized and have excellent time management capabilities. Ability to analyze data to identify trends, and variance from goals.

About us
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.