Provider Administrator

Role Overview

• Work within and across department teams to manage provider and office staff service requests
• Resolve business partner questions/issues and provide call handling/routing to provider support line
• Support provider management activities associated with provider data maintenance, credentialing activities, directory management and intake requests
• Research, resolve, document and accurately respond to provider, practice, business partner or administrator inquiries and service requests
• Communicate and coordinate with providers, practices and other departments to ensure accurate information is available to support business needs
• Manage the Committee meetings set up, document Committee findings in the formal meeting minutes and notify staff of Committee decisions
• Monitor and maintain critical provider information in various systems
• Review team member quality assurance reports on a regular basis and work with leadership to prepare follow-up documentation
• Act as first-level intake and triage for incoming provider call line, data clean-up efforts and specified team email box requests
• Support the client and regulatory audit process to include pulling required documentation and review of provider files for accuracy
• Gain industry knowledge to support internal and external business partner relationships
• Support the recredentialing process and audit support functions to NCQA and client standards
• Ensure requested information is delivered within specified timeframe and completed accurately
• Maintain high standards in all written or verbal communications with providers

Requirements

• Two to four years of general office experience
• Proficient with word and spreadsheet applications
• Ability to read and write at a level necessary to accomplish the above tasks
• Demonstrated ability to identify problems and provide creative solutions
• Strong attention to detail, organizational skills and problem solving skills
• Excellent written and verbal communication skills
• Ability to work independently and in a team environment

Benefits

• Eligible bonuses and commissions
• Health benefits