Calling for creative individuals to join a robust team in the Houston area. This prestigious nationally recognized Health Plan organization is looking forward to growing their Houston location. Located close to the Westchase/ Clodine/ Mission Bend area with access to great lunch options in the area.
Looking for individuals with experience in the administrative sector of healthcare. Will be responsible for resolving claim and payment issues, answering incoming calls to help resolve various issues. High attention to detail is a plus as this role involves reviewing and processing incoming and outgoing paperwork, directory updates, provider credentialing applications, and contract maintenance forms. Provides office project management, provider recruitment and data analysis support.
Working hours: 8:00 AM - 5:00 PM
-Works alongside internal and external partners to collect all required information to ensure correct processing of contracts, amendments and update requests.
-Works with delegated providers and IPAs to process new provider load requests along with any updates or changes within the group via a roster methodology.
-Supports the Provider Relations Representatives in resolving claims and payment issues.
-Performs root cause analysis of delays in provider loading and assists in bringing to resolution.
-Audits configuration loads on new contracts.
-Excel, Word, Outlook
-Interpersonal and Verbal Communication Skills
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