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Provider Relations-Networking-Contracting WellCare - Provider Administration & Support Careers

Provider Contract Coordinator Job

Full Job Title: Provider Contract Coordinator

Job Number: 1800541

Location: Chicago, IL

Date Posted: 1-24-2018

To ensure accurate and timely loading of provider records and maintenance of provider database.

Essential Functions:
  • Loads & maintains provider data as received from contracted IPA/Medical Groups.
  • Coordinates with the enrollment department for member move requests.
  • Loads & maintains Hospital and Ancillary records via updates from the Provider Services & Contracting department.
  • Ensures the proper documentation exists and is maintained on file for all load processes.
  • Trouble shoots provider configuration for claims processing.
  • Resolves critical errors forwarded from the claims department.
  • Processes and corrects encounter data records for submission.
  • Updates provider records for UM department for accurate authorization linkages.
  • Creates provider files for updates to online provider directory.
  • Performs other duties as assigned.
Additional Responsibilities:Candidate Education:
  • Required A High School or GED
Candidate Experience:
  • Preferred 6 months of experience in data entry and/or customer service
  • Preferred 1 year of experience in Health Insurance Industry
Candidate Skills:
  • Beginner Other Basic understanding of provider data and how it is loaded in systems
  • Beginner Other General understanding of provider maintenance and termination processes
  • Beginner Other Basic knowledge of provider billing practices Knowledge of claims processing
Licenses and Certifications:Technical Skills:
  • Required Intermediate Microsoft Word
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Outlook
Languages:

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Last Updated On: 12/9/2015