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

Provider Operations Coordinator - Senior Job

Full Job Title: *Provider Operations Coordinator, Sr

Job Number: 1804823

Location: Phoenix, AZ

Date Posted: 2018-07-03

This position is for Care1st Health Plan, a WellCare Health Plans, Inc. company.

Department: Provider Relations - Medicaid

Reports to: Network Management Manager

Location: E. Camelback Rd, Phoenix AZ 85016

Job Type: Hourly/ Non-exempt

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.

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Last Updated On: 12/9/2015