Provider Administration Coordinator

Blue Cross & Blue Shield of Mississippi; Flowood (MS); Presencial; USD 42.000 - 62.000; Jornada completa

Descripción de la vacante

Blue Cross & Blue Shield of Mississippi is seeking a Provider Administration Coordinator to manage provider contracting documentation and directory information. You will own provider contract inventories, maintain templates, and ensure accuracy with reimbursement schedules and provider profiles.

The role includes publishing reports, coordinating contract changes, and assisting with credentialing for Disease Specific Pharmacy providers, while serving as a back-up for provider inquiries.

Formación

• Bachelor’s degree in a business related field.
• 2 years’ experience in provider networks or provider office administration or two years’ customer service experience with BCBSMS.
• Strong diplomatic, conflict resolution and negotiating skills.
• Excellent analysis and issue resolution skills.
• Excellent business writing skills.
• Understanding of healthcare provider office management and business processes.
• Strong communication skills.
• Understanding of healthcare benefits and network products.

Responsabilidades

• Maintain provider contracting documentation and directory information.
• Own and maintain Network Provider Contract inventories and templates.
• Bi-annual validation of provider contracts against reimbursement schedules.
• Publish GeoAccess reports and SAS reports for provider information and claim activity.
• Coordinate provider contract changes and provider mail-outs.
• Review provider directories for accuracy across categories and specialties.
• Credentialing activities related to Disease Specific Pharmacy providers.
• Back-up to Provider Service Specialist for provider inquiries.

Educación

Bachelor’s degree in a business related field

Herramientas

Microsoft Office

Descripción del empleo

Healthy Careers Start Here

Job Summary

The Provider Administration Coordinator is essential in maintaining complete and accurate provider contracting documentation and directory information to meet the service needs of our customers and Network Providers. The Provider Administration Coordinator is responsible for provider administrative activities to include, ownership and maintenance of all Network Provider Contract inventories and contract templates. This position is also accountable to perform bi-annual validation and verification of provider contract completeness against provider reimbursement schedules and maintenance of relational Network Provider profiles, to include provider location changes. The Provider Administration Coordinator will serve as a resource to publish GeoAccess reports to support Network Access requests and SAS reports to support the Provider Information Group with claim activity and claim adjustment requests. The position will also be responsible for facilitation of all provider contract changes, to include provider manuals, contract updates, etc. The Provider Administration Coordinator is also responsible for coordinating and facilitating all provider related mail-outs. This position is accountable to ensure the integrity and accuracy of the Provider Network Directories by conducting a review of all provider categories and provider specialties published in the online directory. The Provider Administration Coordinator is responsible for credentialing activities related to Disease Specific Pharmacy providers. This position is also accountable to serve as back-up to the Provider Service Specialist to ensure timely and accurate response to provider inquiries.

Job-Specific Requirements:

• A Bachelor’s degree in a business related field is required.
• Must have 2 years’ experience in provider networks or provider office administration or two years’ customer service experience with BCBSMS.
• Must have strong diplomatic, conflict resolution and negotiating skills.
• Must have excellent analysis and issue resolution skills.
• Must have excellent business writing skills.
• Must have an excellent understanding of healthcare provider office management and business processes.
• Must have strong communication skills.
• Must have an excellent understanding of healthcare benefits and network products.
• Personal Computer skills required to include the Microsoft Office suite.

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.