Remote Medicare & Medicaid Provider Network Specialist

VIVA USA Inc; Austin (TX); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Remote work

Job summary

VIVA USA Inc. seeks a health insurance provider services professional in Austin, TX.

This remote-capable role supports Medicare and Medicaid provider operations while allowing flexible location within Austin. You will research and resolve provider inquiries arising from contract operations, system data entry, claims, and directory issues, and coordinate with Provider Network, Provider Relations, and Government Programs staff.

Qualifications

• Bachelor degree OR 2 years experience in health insurance/managed care.
• Strong written and verbal communication to educate providers and resolve issues.
• Proficient with Microsoft Word and Excel.
• HS Diploma/GED.
• Bachelor Degree with one year business experience.
• Knowledge of health care industry, contracts, products, claims processing.
• Knowledge of government health care products.
• Strong TX Medicare claims and provider relations knowledge.

Responsibilities

• Support Medicare and Medicaid provider services and provider operations.
• Research and resolve provider inquiries from contract operations, system, data entry claims payment, and directory issues.
• External communications educating and updating the Medicaid and Medicare provider network community regarding client policy updates, system and contractual changes.
• Assist in the composition and coordination of revised policies and procedures.

Skills

Provider relations knowledge

Medicare/Medicaid knowledge

Written & verbal communication

PC proficiency

Education

Bachelor degree or 2 years health insurance/managed care experience

Tools

Microsoft Word

Microsoft Excel

Job description

VIVA USA Inc. seeks a health insurance provider services professional in Austin, TX.

This remote-capable role supports Medicare and Medicaid provider operations while allowing flexible location within Austin. You will research and resolve provider inquiries arising from contract operations, system data entry, claims, and directory issues, and coordinate with Provider Network, Provider Relations, and Government Programs staff.