Provider Network Operations Specialist

Jobtailor; Houston (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

Jobtailor in Houston is seeking a Provider Network Operations professional to support onboarding, terminations, and maintenance of provider records, coordinating activities across contracting, credentialing, claims, and provider relations.

You will investigate provider issues, ensure data accuracy, assist with audits and regulatory reporting, and generate operational reports to drive efficiency and provider experience.

Qualifications

• Experience in provider network operations, provider relations, healthcare operations or managed care.
• Experience supporting provider onboarding, maintenance, claims resolution, credentialing, or network operations.
• Strong organizational skills with attention to detail and accuracy.
• Excellent customer service, communication, and relationship-building skills.

Responsibilities

• Support provider network operations including onboarding, terminations, demographic updates, and provider records maintenance.
• Coordinate provider-related activities across Contracting, Credentialing, Claims, Provider Relations and other internal teams.
• Serve as primary point of contact for provider inquiries, network status questions, and administrative needs.
• Investigate and resolve provider issues related to claims, reimbursement, and network participation.
• Maintain accurate provider records, logs, and workflows; assist with audits and regulatory reporting.
• Compile and distribute operational reports related to provider activities and performance.

Skills

Provider Relations

Healthcare Operations

Credentialing

Contracting Processes

Claims Operations

Data Accuracy

Operational Workflows

Process Improvement

Audit Preparation

Network Participation

Education

Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or related field

Tools

Microsoft Office Suite

Provider Management Systems

Healthcare Platforms

Network Databases

Job description

Jobtailor in Houston is seeking a Provider Network Operations professional to support onboarding, terminations, and maintenance of provider records, coordinating activities across contracting, credentialing, claims, and provider relations.

You will investigate provider issues, ensure data accuracy, assist with audits and regulatory reporting, and generate operational reports to drive efficiency and provider experience.