Provider Network Coordinator

Wellfleet Health Insurance Position

Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life from grade school to college to the workplace.

Founded in 1993 as Consolidated Health Plans (CHP), Wellfleet, headquartered in Springfield, Mass., is one of the nation's leading providers of health and accident insurance products to the higher education market.

Join our rapidly growing and fast paced health insurance organization in the Springfield area. The ideal candidate in this position will have an insurance background, or claims paying experience and will be responsible for the timely adjudication of claims (medical, accident, dental, life, etc.) in support of the different product lines administered by Wellfleet.

In this role, you will...

• Receive, review, and maintain efficient processing of provider enrollment, credentialing and recredentialing applications for direct contracts on behalf of health insurance plans
• Verify and analyze provider credentialing applications and supporting documentation for completeness and accuracy
• Review provider licenses, certifications, and other relevant documents to confirm credentials are valid and current. Utilize the OIG sanctions database for further verification
• Maintain detailed database of providers for initial credentialing and recredentialing renewal dates as well as for reporting purposes
• Communicate with and respond to inquiries from providers regarding process and documentation of initial credentialing and recredentialing applications
• Assist with Member Satisfaction Survey generation, response analysis and tracking to identify ways to improve the member experience
• Assist with implementing new vendor set ups and provide support with ongoing vendor maintenance
• Participate in vendor oversight calls and meetings and document meeting minutes
• Research and provide timely and thorough resolutions to vendors and providers on their inquiries or issues
• Assist the Head of Provider & Network Management and Provider & Network Manager on ad hoc projects that support the Provider Network Team and benefit the company as a whole
• Perform other duties as assigned.

We are looking for candidates with...

Why Wellfleet? Here at Wellfleet, we foster a culture of growth that enables engaged and high-performing professionals to be empowered to deliver our mission and vision.

Our employees are a team devoted to providing customer service that exceeds expectations of our members and clients. Successful team members continually look for ways to improve product delivery and value.

Wellfleet offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible / dependent care spending account, tuition reimbursement, and business casual dress.

Are you interested in exploring a career at Wellfleet? Explore our open positions.