Healthcare Network Specialist

6 days ago


Baton Rouge, Louisiana, United States Baton Rouge General Full time
Job Summary

Baton Rouge General is seeking a highly skilled and detail-oriented Provider Enrollment Specialist to join our team. As a key member of our operations team, you will be responsible for building and maintaining positive relationships with network providers and members, ensuring seamless enrollment and credentialing processes.

Key Responsibilities
  • Provider Engagement: Develop and maintain effective communication channels with network providers and health plan members to ensure high-quality service delivery.
  • Credentialing and Enrollment: Compile, analyze, and verify provider data elements for completeness and accuracy, ensuring timely and efficient enrollment processes.
  • Provider Data Management: Gather, review, and verify provider demographic data elements related to changes, additions, and terminations, ensuring accurate and up-to-date information.
  • Issue Resolution: Communicate with providers and external credentialing verification representatives to resolve questions and issues regarding updates and changes in the systems.
  • Process Improvement: Identify opportunities for process improvement and recommend changes to enhance daily operations and provider satisfaction.
  • Team Collaboration: Coordinate provider interactions with the entire team to ensure seamless communication and high-quality service delivery.
Requirements
  • Education: College degree or equivalent work experience.
  • Experience: 2 years of credentialing, enrollment, and/or insurance operations experience, with a preference for healthcare experience.
  • Skills: Strong attention to detail, excellent organization skills, ability to manage multiple priorities, and proficiency in Microsoft Office Suite.
  • Personal Qualities: Ability to work independently, strong communication skills, and a professional demeanor.


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