Network Operations Coordinator

at  Humana

BECOME A PART OF OUR CARING COMMUNITY AND HELP US PUT HEALTH FIRST

The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations.
The Network Operations Coordinator 3 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manages provider perceived service failures. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques. Works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.

REQUIRED QUALIFICATIONS

• High School Diploma or equivalent
• 1 + years of prior experience in an administrative, customer support, or healthcare
• Intermediate skills with Microsoft Word and Excel
• Ability to work in a deadline driven environment
• Strong attention to detail
• Strong written and verbal communication skills

PREFERRED QUALIFICATIONS

• Prior experience working in the healthcare insurance industry
• Previous experience in claims
• Prior contract interpretation experience

DESCRIPTION OF BENEFITS

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

ABOUT US

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Please refer the Job description for details