Humana Network Operations Coordinator 3- Torrance, CA in Torrance, California

Description

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 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

Responsibilities

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 manage provider perceived service failures. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and 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 or customer support role

  • Intermediate skills with Microsoft Word and Excel

  • Ability to work in a deadline driven environment

Preferred Qualifications

  • Prior experience working in the healthcare insurance industry

  • Previous experience in claims

  • Prior contract interpretation experience

Additional Information

Scheduled Weekly Hours

40

About Us

Equal Opportunity Employer

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