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

Provider Operations Coordinator Job

Full Job Title: Provider Operations Coordinator

Job Number: 1800135

Location: Buffalo, NY

Date Posted: 1-19-2018

Supports the Provider Relations Field Representative to achieve department goals. Responds to customer service and provider relations inquiries from providers and assist with problem resolution of issues. Coordinates provider submissions to internal departments via required forms.

Department: Provider Relations

Reports to: Supv, Provider Operations

Essential Functions:

  • Works directly with internal and external partners to collect all required information to ensure correct processing of contracts, amendments and update requests.
  • Works with delegated providers and IPAs to process new provider load requests along with any updates or changes within the group via a roster methodology.
  • Supports the Provider Relations Representatives in resolving claims and payment issues.
  • Performs root cause analysis of delays in provider loading and assists in bringing to resolution.
  • Audits configuration loads on new contracts.
  • Provides office, project management, provider recruitment and data analysis support.
  • Performs special projects as assigned or directed.
Additional Responsibilities:
  • May support provider enrollment and credentialing activities.
Candidate Education:
  • Required A High School or GED
  • Preferred An Associate's Degree in a related field
Candidate Experience:
  • Required 1 year of experience in customer service or claims with exposure to problem resolution
  • Preferred 1 year of experience in physician credentialing
Candidate Skills:
  • Intermediate Demonstrated problem solving skills
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Demonstrated written communication skills
  • Intermediate Demonstrated organizational skills
  • Intermediate Demonstrated time management and priority setting skills
  • Intermediate Demonstrated analytical skills
Licenses and Certifications:
A license in one of the following is required:
Technical Skills:
  • Required Intermediate Microsoft Outlook
  • Required Beginner Microsoft Word
  • Required Intermediate Microsoft Excel
  • Preferred Beginner SalesForce
  • Preferred Beginner Xcelys

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Last Updated On: 12/9/2015