Provider Network Coordinator I (Provider experience required)

Job Summary :

The Provider Network Coordinator I is responsible for the integrity of the data in the provider database system.

Essential Functions :

• Responsible for the integrity of the data in the provider database system
• Accurately load provider records for all products and markets into the provider database for use by various internal departments, providers, and our member community
• Ensure all participating providers have successfully completed credentialing and contracting prior to loading; work with the appropriate team to meet these requirements when necessary
• Ensure valid documentation is available prior to loading or performing maintenance on provider records and collaborate with various functions to resolve issues when necessary
• Meet aggressive Service Level Agreements (SLAs) for processing data
• Adhere to requirements established by external governing bodies such as various state or federal entities
• Accurately track daily activities through detail workflow queues to meet established productivity and timeliness standards
• Research and resolve provider data inquiries for various internal departments
• Respond to emails, phone calls and written requests from providers and internal customers while providing consistent and clear communication
• Serve as a subject-matter expert for the provider database system content and logic behind daily processing
• Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvements and to identify issues
• Continually evaluate current processes for improvement opportunities, submit potential enhancements to management, and participate in process improvement activities
• Assist in various mandatory projects such as data cleanup, workflow revisions, upkeep of maintenance and other projects as assigned
• Perform any other job duties as requested

Education and Experience :

Competencies, Knowledge and Skills :

Licensure and Certification :

Working Conditions :

Compensation Range :

$35,200.00 - $56,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type : Hourly

Competencies :

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

#LI-SD1