Coordinator Provider Network
Company: AmeriHealth Caritas
Posted on: January 25, 2023
Coordinator Provider NetworkLocation: Manchester, NHPrimary Job
Function: Medical ManagementID**: 27124Your career starts now. Were
looking for the next generation of health care leaders.At
AmeriHealth Caritas, were passionate about helping people get care,
stay well and build healthy communities. As one of the nation's
leaders in health care solutions, we offer our associates the
opportunity to impact the lives of millions of people through our
national footprint of products, services and award-winning
programs. AmeriHealth Caritas is seeking talented, passionate
individuals to join our team. Together we can build healthier
communities. If you want to make a difference, wed like to hear
from you.Headquartered in Philadelphia, AmeriHealth Caritas is a
mission-driven organization with more than 30 years of experience.
We deliver comprehensive, outcomes-driven care to those who need it
most. We offer integrated managed care products, pharmaceutical
benefit management and specialty pharmacy services, behavioral
health services, and other administrative services. Discover more
about us at www.amerihealthcaritas.com .Responsibilities:The
Coordinator, Provider Network Operations reports directly to the
Director, Provider Network Operations and supports the Provider
Network Operations team in managing Plan operational functions and
activities; key responsibilities include:
- Coordinating and facilitating administrative activities
including meetings and material development (P&Ps, desk
procedures, workflows, etc.)
- Assessing and triaging incoming provider issues while
maintaining tracking database(s) and ensuring that operational
issues are being worked and resolved in a timely manner
- Preparing high-visibility reports that outline the operational
status of key provider escalations and issues
- Assisting Provider Network Operations staff as necessary to
assess and correct issues being encountered by providers and other
internal staff; to include submitting requests to various
operational areas via Service Form (SF), or other methods, to
update provider information, run claim reports or projects,
- Analyzing and trending reports to identify outliers and areas
- Managing and routing state requests and inquiries to
appropriate functional areas while ensuring timely responses
- Assisting in drafting and/or finalizing formal correspondence
- Engaging, developing and maintaining multiple customer
relationships, establishing trust and open
- Associates Degree preferred or equivalent combination of
education and work experience in a Health Care field
- 3-5 years office experience.
- Previous claims, healthcare, managed care or insurance industry
- Must be proficient in Microsoft Office products.
- Superior organizational skills required.
- Critical thinking skills.
- Billing and coding experience/knowledge a plus.
- Strong customer service skills.
- Excellent written and verbal communication.
- Track record of Customer Excellence.
- Demonstrated ability to coordinate activities across functional
- Sound personal management skills to plan, organize, schedule,
and complete own work and work that is coordinated with others.EOE
Keywords: AmeriHealth Caritas, Manchester , Coordinator Provider Network, Other , Manchester, New Hampshire
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