Employer Industry: Healthcare Services

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Fully remote position, offering flexibility in work location
- Engage in a high-performance culture focused on improving member health and satisfaction
- Work within a dynamic and supportive environment that values employee contributions
- Chance to be part of an organization committed to delivering quality service to its members

What to Expect (Job Responsibilities):
- Manage all aspects of provider enrollment, including maintaining and validating provider demographics and directory accuracy
- Collaborate with department leadership to develop and implement processes for monitoring contractual obligations
- Support the Provider Relations Team with contracting activities, including follow-ups and documentation for the Plan's claim system
- Identify process improvement opportunities and develop plans to address them
- Ensure compliance with all relevant regulations and contractual obligations

What is Required (Qualifications):
- High School Diploma or equivalent (GED)
- Two (2) years of experience and knowledge of HMO, PPO, TPA, and managed care functions

How to Stand Out (Preferred Qualifications):
- Associate degree in business, healthcare, or a related field
- Two (2) years of healthcare claims and/or billing experience with a basic understanding of payment methodology and medical terminology

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