Provider Administration Coordinator

Blue Cross & Blue Shield of Mississippi; United States; On-site; USD 52,000 - 76,000; Full time

Job summary

Blue Cross & Blue Shield of Mississippi is seeking a Provider Administration Coordinator to maintain provider contracting documents and directory information. You will own contract inventories, templates, and bi-annual validations to ensure accuracy and alignment with reimbursement schedules.

You will publish GeoAccess and SAS reports to support network access requests and assist with provider information management, contract changes, and provider inquiries.

Qualifications

• Bachelor's degree in a business-related field required.
• 2 years’ experience in provider networks or provider office administration or customer service 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.

Responsibilities

• Maintain provider contracting documentation and directory information.
• Own and maintain all Network Provider Contract inventories and templates.
• Bi-annual validation of provider contract completeness against reimbursement schedules.
• Publish GeoAccess reports to support Network Access requests and SAS reports for Provider Information Group.
• Coordinate provider contract changes, manuals, and updates.
• Coordinate provider-related mail-outs.
• Review provider categories and specialties in the online directory for accuracy.
• Credentialing activities related to Disease Specific Pharmacy providers.
• Serve as back-up to Provider Service Specialist for provider inquiries.

Education

Bachelor's degree in business-related field

Tools

Microsoft Office

Job description

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. At Blue Cross & Blue Shield of Mississippi, we work daily to help Mississippians find their personal answers to this question through health and wellness partnerships with quality healthcare providers, employer groups and community leaders across the state. Our goal is to help each person along their journey to a healthier life… their Blue Wellness Journey. Our health and wellness benefits are designed to support our members in understanding their health and in receiving the care they need at the right time and place, beginning with establishing a healthy relationship with a Primary Care Network Provider through an annual wellness visit at no out-of-pocket cost. We partner with our Network Providers to ensure the highest quality, evidence-based care is provided in each care setting from primary care to specialty care through our Primary Care Home, Blue Distinction+ Centers of Excellence and Maternity Care Quality initiatives. We partner with employer groups to make every workplace a healthy workplace by providing tools and information to help employees take ownership of their health and understand and make the most of their benefits, all while working to manage health and healthcare costs. We partner with community leaders and organizations to make healthy living resources available to all Mississippians through the work of the Blue Cross & Blue Shield of Mississippi Foundation, our support of the arts and culture and our Team Blue volunteers. These partnerships and our dedicated team of employees are making a difference every day, in our communities and in the lives of each person we reach. So, what does it mean to be healthy? The answer is about you, your health, your life… and all its possibilities. Live healthy. Live Blue.