Remote Provider Network Analyst - Medicare/Medicaid

W3R Consulting; Austin (TX); Remote; USD 39,000 - 44,000; Full time

Job summary

W3R Consulting is seeking a Health Insurance Provider Services Coordinator to support Medicare and Medicaid provider operations remotely. You will research and resolve provider inquiries arising from contract operations, system issues, data entry, claims payment, and directory accuracy.

You will collaborate with Provider Network, Provider Relations, and Government Programs teams to resolve issues and educate Medicaid and Medicare providers about policy updates, system changes, and contract

Qualifications

• Bachelor degree OR 2 years in health insurance/managed care handling independent decisions.
• Strong written and verbal communication to educate providers and resolve issues across departments.
• Proficiency in Word and Excel.
• HS Diploma/GED
• Strong Texas Medicare claims and provider relations knowledge.

Responsibilities

• Research and resolve provider inquiries arising from contract operations, system, data entry claims payment, and directory issues.
• Coordinate with Provider Network, Provider Relations, and Government Programs staff on issue resolution.
• Educate and update Medicaid and Medicare provider network regarding policy updates, system changes, and contract changes.
• Assist in the composition and coordination of revised policies and procedures.

Skills

Health insurance knowledge

Provider relations

Communication skills

Excel

Education

Bachelor degree OR 2 year experience

Tools

Word

Excel

Job description

W3R Consulting is seeking a Health Insurance Provider Services Coordinator to support Medicare and Medicaid provider operations remotely. You will research and resolve provider inquiries arising from contract operations, system issues, data entry, claims payment, and directory accuracy.

You will collaborate with Provider Network, Provider Relations, and Government Programs teams to resolve issues and educate Medicaid and Medicare providers about policy updates, system changes, and contract