Coordinador(a) De Administración De La Red

MCS Health; San Juan (PR); Vor Ort; USD 40.000 - 56.000; Vollzeit

Zusammenfassung

MCS Health in San Juan, Puerto Rico seeks an Administrative Coordinator to coordinate, route, and follow up on operational requests within the department, ensuring compliance and efficient service.

The role involves managing communications with providers, preparing documents, and supporting audits, using CRM and credentialing platforms; this is a non-exempt, regular position.

Qualifikationen

• Bachelor's degree in Secretarial Science, Office Systems, or Business Administration.
• At least 6 months' experience performing provider services, network administration, and/or coordination.
• Associate's degree with 1 year of relevant experience.
• High School Diploma with 2 years of relevant experience.
• Proven experience may be replaced by established requirements.
• Certifications or licenses not required.

Aufgaben

• Receives, documents, and routes network administration requests from multiple channels.
• Monitors requests in internal systems to ensure timely responses and compliance.
• Manages communications with providers and internal teams; reports risks.
• Prepares logs, agreements, credentialing files, provider lists, and contracts per policies.
• Coordinates meetings, minutes, agendas, and operational activities.
• Maintains physical and digital records for audits and inquiries.
• Reports operational information and metrics to support decision‑making.
• Performs basic validations in internal systems to verify provider status.
• Supports audits and regulatory initiatives in line with local and federal rules.
• Uses CRM, SAI 360, and credentialing platforms as needed.

Kenntnisse

Provider services

Network coordination

Documentation management

Regulatory compliance

Meeting coordination

CRM usage

Ausbildung

Bachelor's degree in Secretarial Science / Office Systems / Business Administration

Associate's degree or 60-64 credits

High School Diploma or Technical Course

Tools

CRM

SAI 360

Credentialing Digital Platform

Jobbeschreibung

Regular

Non-Exempt

GENERAL DESCRIPTION:

Responsible for coordinating, routing, and following up on operational requests related to the department and/or unit. Provides administrative support, manages documentation, and ensures compliance with internal processes and regulatory requirements, contributing to operational efficiency and service quality.

ESSENTIAL FUNCTIONS:

• Receives, documents, and routes operational requests related to the network administration from various internal and external channels.
• Monitors and follows up on requests using internal systems and electronic platforms to ensure timely responses, traceability, and compliance with regulatory requirements.
• Manages communications (phone, email, fax, regular mail, or in-person) with providers and internal teams, routing inquiries and reporting potential risks.
• Prepares logs and files administrative documents such as letters of agreement, reports, credentialing files review, provider’s exclusion lists, letters to providers, letters to impacted membership, and contracts in compliance with applicable internal and external policies and regulations, as applicable.
• Coordinates meetings, minutes, agendas, and operational activities with providers, external resources, and or internal teams based on business needs.
• Organizes, maintains, or provides physical and digital records to ensure availability for audits, inspections, or internal inquiries upon request.
• Collaborates with other administrative areas and delegated entities to ensure consistency and efficiency in processes supporting the network administration.
• Consolidates and reports operational information to support decision‑making, including status updates, operational metrics, and compliance alerts.
• Performs basic validations in internal systems to support the verification of provider status and requirements.
• Participates in special initiatives, audits, and other organizational activities related to the network, following regulatory requirements from local and federal agencies.
• Perform tasks using the appropriate operational software platforms relevant to the unit’s functions, such as Customer Relationship Management (CRM), SAI 360, and Credentialing Digital Platform from the Office of Insurance Commissioner, National Practitioner Data Bank, Puerto Rico Medical Licensing Board, and or any other internal or external platform upon request.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Bachelor's Degree in Secretarial Science, Office Systems, or Business Administration. At least six (6) months of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

OR

Education and Experience: Associate's Degree or at least sixty to sixty-four (60-64) approved college credits. At least one (1) year of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

OR

Education and Experience: High School Diploma or Technical Course. At least two (2) years of experience performing provider services, network administration, and/or coordination functions, preferably in the Healthcare Insurance Industry.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: Not required.

Other: N/A

Languages:

Spanish – Intermediate (comprehensive, writing and verbal)

English – Intermediate (comprehensive, writing and verbal)

“We are an Equal Employment Opportunity Employer and take Aff…?”

MCS Healthcare Holdings, LLC. (MCS)is an Equal Employment Opportunity Employer and take Aff…?