Provider Network Administration Specialist

4 weeks ago


Indianapolis, Indiana, United States Professional Management Enterprises Full time
Provider Network Administration

As a key member of our team at Professional Management Enterprises, the Provider Network Administration Specialist will play a vital role in ensuring the accuracy and timeliness of critical provider information on all claims and provider databases. This position requires a strong understanding of business and system requirements, as well as excellent communication skills to work effectively with internal customers and stakeholders.

Key Responsibilities:

  • Generate and prepare provider-related data and reports to support Network Management and Operations areas of responsibility.
  • Provide timely and accurate generation and distribution of required reports to support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations.

Requirements:

  • 1-year experience in Provider Claims and/or Provider Network Administration.
  • Intermediate skill level in QNXT, Access, and Excel.

Preferred Qualifications:

  • 1-year managed care experience.
  • 1 year experience in Medical Terminology, CPT, ICD-9 codes, etc.

Education:
High School Diploma or equivalent.

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