Network coordinator job description

The Provider Network Coordinator I is responsible for the integrity of the data in the provider database system.
Essential Functions:
Responsible for the integrity of the data in the provider database system Accurately load provider records for all products and markets into the provider database for use by various internal departments, providers, and our member community Ensure all participating providers have successfully completed credentialing and contracting prior to loading; work with the appropriate team to meet these requirements when necessary Ensure valid documentation is available prior to loading or performing maintenance on provider records and collaborate with various functions to resolve issues when necessary Meet aggressive Service Level Agreements (SLAs) for processing data Adhere to requirements established by external governing bodies such as various state or federal entities Accurately track daily activities through detail workflow queues to meet established productivity and timeliness standards Research and resolve provider data inquiries for various internal departments Respond to emails, phone calls and written requests from providers and internal customers while providing consistent and clear communication Serve as a subject-matter expert for the provider database system content and logic behind daily processing Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvements and to identify issues Continually evaluate current processes for improvement opportunities, submit potential enhancements to management, and participate in process improvement activities Assist in various mandatory projects such as data cleanup, workflow revisions, upkeep of maintenance and other projects as assigned Perform any other job duties as requested

Education and Experience:
Minimum of High School Diploma or General Equivalency Degree (GED) is required Associates Degree in a healthcare related field is preferred Minimum of two (2) years of experience in a managed care environment is preferred Experience using Cactus and Facets is preferred

Competencies, Knowledge and Skills:
Proficiency with Microsoft Office, including Outlook, Word, and Excel is required.High speed and accurate data entry skills Knowledge of Medicaid & Medicare managed care is preferred Solid verbal and written communication skills Ability to work independently and within a team environment Time management skills Critical listening and thinking skills Solid decision making/problem solving skills Attention to detail Customer-service oriented

Licensure and Certification:
None

Working Conditions:
General office environment; may be required to sit or stand for extended periods of time

Organization Level Competencies
Leveraging FeedbackCustomer OrientationValuing DifferencesManaging WorkEarning TrustQuality OrientationAdaptabilityInfluencingCollaborating

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.

Join our Ardent Health Services team as a Provider Network Coordinator!


Ardent Health Services is a premier provider of health care services that invests in people, technology, facilities, and communities, producing high-quality care and extraordinary results. We are driven in all things by our purpose of caring for people: our patients, their families, and one another. Based in Nashville, Tennessee, Ardent's subsidiaries own and operate 30 hospitals, 180 clinics, and a variety of other related health care facilities in six states; we employ 26,000 associates, including 1,000+ employed providers. Ardent facilities exceed national averages in Overall Hospital Quality Star Rating as ranked by the Centers for Medicare & Medicaid Services, with 89 percent of our hospitals receiving a three-star rating or above. Ardent's corporate office has been named one of the \"Top Work Places\" among Nashville-based companies for five consecutive years, including 2021.


POSITION SUMMARY


We have an exciting opportunity to join our Corporate Payer Strategies team as a
Provider
Network Coordinator.
The Provider Network Coordinator will support BSA Health System in Amarillo, TX.


Responsibilities



Coordinates and oversees all aspects of Provider Network provider database including: Maintenance of provider panels for contracted payors Maintenance of opt-ins for messenger contracts Billing for provider network credentialing fees Support of network contracting and re-contracting initiatives Maintains an organized filing system for both provider and payor contracts Coordinates with Manager, provider fee schedules specific to each payor Serve as a liaison for provider claim issues Credentialing and Recredentialing of: BSAHS and J/V facilities BSAPN participating facilities Answers incoming Provider Network calls Handles all accounts receivable and payable for Network Medical Advisory Committee meetings support: attendance, preparation of files, follow up Assists manager, director, provider relations representative with special projects, as requested
Qualifications



Education:


Bachelor's degree preferred
Experience:


In lieu of degree, five (5) years medical office or payor experience Strong clerical and accounting background Experience in communicating with professionals, conflict resolution Healthcare/medical office work history Fully competent in Microsoft Office including Word, Access, and Excel Must become proficient in EPIC system within six (6) months of hire
Knowledge, Skills, & Abilities:


Position requires fluency in English language to function in job environment appropriately Good interpersonal and customer service skills Good organizational and follow-through skills Ability to multi-task constantly and tolerate interruptions
Behavior Standards:


Service - Patient Centered Customer Service Quality - Clinical and Operational Excellence People - Promotes a Collaborative Environment Financial - Business Acumen Growth - Fosters Innovation

Who we are looking for:

Are you the Prevention Network Coordinator we have been looking for? In this position you will be able to convey your passion for helping others by working with people in the community! GLASS provides a continuum of services to LGBTQ+ youth of color and their allies. Our staff work to improve the well-being of LGBTQ youth of color and their allies by providing a continuum of services that addresses their immediate needs, equips them with tools to make healthy decisions and live fulfilling lives, and helps create communities in which they can thrive. GLASS offers behavioral health services, prevention and STI testing services, health navigation, and hosts a drop in center which provides access to social, educational, and leadership opportunities. Further, as a leader in LGBTQ+ youth services, we also provide education and consultation to other providers and community organizations.

JRI provides the training so that:

YOU will oversee and provide the Prevention Network's HIV prevention services including digital and in-person outreach, client recruitment/retention efforts, individual and group-level interventions, and educational activities for LGBTQ+ youth of color, ages 13-29 (with a focus on Black and Latinx MSM and transgender individuals).
YOU will train and supervise the Prevention Network team and work collaboratively with GLASS, JRI Health programs, and community partners.
YOU will guide the Prevention Network team towards meeting program goals and objectives, and provide leadership around data collection, quality assurance, and quarterly reporting.

Why JRI?

Be who you are! JRI is strongly committed to providing an inclusive, diverse and welcoming environment for our employees and the people we serve.
Access to our excellent Blue Cross medical and Delta Dental benefits.
Retirement benefits including 401K matched up to $800 a year and pension after 5 years of employment.
Professional development opportunities such as tuition reimbursement up to almost $4,000 per year and discounted tuition rates to select partnership colleges and universities!
Wellness benefits including access to employee resource groups (including multicultural affinity groups, LGBTQ+ advocacy, employee engagement groups, etc.), self-care resources, and an Employee Assistance Program.
Generous paid time off up to 19 days for full time employees in your first year and much more!

Requirements:

Candidates should have Bachelor's degree in a related field or combination of education and experience that demonstrates capability to succeed in this position.
Candidates should have knowledge of positive youth development, trauma-informed practice, and harm reduction approaches as well as knowledge of substance use disorders, HIV/STI, and related public health/social service topics.
Candidates should have knowledge of social media and social marketing strategies.
Candidates should have a commitment to social justice mission and principles of cultural responsiveness. They should demonstrate cultural sensitivity and knowledge of diverse youth populations, including Black, Latinx, and LGBTQ youth cultures.
Candidates should have excellent written and oral communication skills.
Candidates should have the ability to connect with youth through outreach, education, support, and counseling.
Candidates should have the ability to supervise others to meet contractual objectives.
Candidates should have outstanding interpersonal skills and the ability to work well on a team.
Candidates should be available to work evenings, holidays, weekend shifts as necessary. Candidates should be able to work alone in an unsupervised and/or virtual environment.
Candidates with diverse background and bilingual capacity strongly encouraged to apply (Spanish-speaking candidates are preferred).
Background and driving record checks will be performed.

JRI is strongly committed to providing an inclusive, diverse and welcoming environment for our employees and the people we serve. Persons from diverse backgrounds including women, communities of color, the LGBTQ community and people with disabilities are encouraged to apply. JRI is an equal opportunity employer.

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