Provider Operations Coordinator

Hamden, CT 06518 | 3 Months

Post Date: 04/27/18 Job ID: WCG1JP00004684 Industry: Other

Date Last Revised: 12/16/2013 ---- FLSA Classification:: Non-Exempt ---- Job Function/Family: State\Provider Solutions ---- JOB SUMMARY ---- Supports the Provider Relations Field Representative to achieve department goals. Answer incoming telephone inquiries from providers and assist with problem resolution of issues. Coordinate submission of provider to internal departments via contract maintenance forms. ---- ESSENTIAL FUNCTIONS ---- Note: The following is not intended to be an exhaustive list of all duties required of this position ---- Key Duties and Responsibilities ---- Supports the Provider Relations Field Reps to resolve claims and payment issues.---Answers incoming telephone inquiries from providers and assist with problem resolution of issues.---Root cause analysis of operational and health services issues.---Reviews and processes incoming and outgoing paperwork. including directory updates. provider credentialing applications. contract maintenance forms and other related forms.---Tracks new contracts through sidewinder.---Audits configuration loads on new contracts.---Provides office. project management. provider recruitment and data analysis support.---Performs special projects as assigned or directed. ---- Additional Position Responsibilities ? Optional ---- ---- MINIMUM QUALIFICATIONS ---- Education ---- State the minimum required for the job ---- Education Level Education Details Required/Preferred ---- A High School or GED Required---An Associate's Degree in a related field Preferred ---- Work Experience ---- State the minimum required for the job ---- Experience Level Experience Details Required/Preferred ---- 1+ year of experience in customer service or claims with exposure to problem resolution Required---No Experience Required ---- Licenses and Certifications ---- List professional licenses and certifications associated with this job ---- Licenses/Certifications Other Licenses/Certifications Required/Preferred ---- ---- Skills ---- State the minimum required for the job ---- Skill Sets Other Skills Proficiency ---- Demonstrated problem solving skills Beginner---Demonstrated interpersonal/verbal communication skills Intermediate---Demonstrated written communication skills Beginner---Demonstrated organizational skills Intermediate---Demonstrated time management and priority setting skills Intermediate---Demonstrated analytical skills Intermediate ---- Technology ---- List technical skills associated with the job ---- Technology Other Technology Proficiency Required/Preferred ---- Microsoft Outlook Intermediate Required---Microsoft Word Beginner Required---Microsoft Excel Beginner Required---SalesForce Beginner Preferred---Sidewinder Beginner Preferred ---- Languages ---- List all that apply ---- Languages Other Languages Required/Preferred ---- ---- SCOPE ---- Level of Supervision Received: ---- A statement which describes the level of independence for this position. ---- [X] Under general supervision. proceeds alone on regular duties. referring questionable cases to supervisor. ---- Level of Supervision Exercised: ---- (Select all that apply) Positions Supervised ---- [X] Individual Contributor 1 [ ] (Please check all that apply) ---- Impact: ---- A statement which describes the impact to the company regarding contributions. decisions. recommendations or actions taken by the incumbent. ---- [X] Failure to accomplish results can normally be overcome without significant effect on the organization ---- Problem Complexity: ---- A statement which describes how clearly a problem is defined when presented. how much additional effort is required to understand the nature of the problem and the typical timescales for resolution. ---- [X] Provides resolution to problems that are readily identifiable with limited scope and are resolved in accordance with standard practices. procedures. applications or routines. ---- PHYSICAL DEMANDS AND WORKING CONDITIONS ---- Physical Demands ---- While performing the duties of this job. the associate is required to meet the following physical demands: ---- ---- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job_ Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ---- Working Conditions ---- While performing the duties of this job. the associate is required to meet the following working conditions: ---- Working Condition None Seldom Occasionally Frequently ---- ---- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job_ Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ---- Travel Requirements 


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