Provider Network Coordinator

2 weeks ago


Los Angeles, California, United States Los Angeles Jewish Home Full time
Job Title: Provider Network Assistant

We are seeking a highly organized and detail-oriented Provider Network Assistant to join our team at Los Angeles Jewish Home. As a key member of our Provider Network team, you will play a critical role in maintaining and developing our network of healthcare providers.

Responsibilities:
  • Assist with the initiation, management, and renewal of provider contracts, ensuring compliance with federal, state, and local authorities and regulators.
  • Stay up-to-date on federal, state, local, and private reimbursement schedules applicable to assigned categories of providers.
  • Maintain and update the provider/vendor database accurately and in a timely fashion.
  • Review and resolve questionable claims, coordinating with necessary personnel and providers.
  • Interact with other departments to answer provider questions and resolve problems, including claims-related issues.
  • Participate in BCSC meetings, assist with marketing on community outreach and enrollment, and contribute to community health-related projects as needed.
  • Assist with regulatory audit preparation and ensure readiness.
  • Comply with safety policies and procedures, identifying and reporting any potential or actual unsafe acts or conditions.
  • Consistently meet or exceed BCSC targets for productivity, customer service, and participant satisfaction.
Requirements:
  • Bachelor's Degree in any field or equivalent experience preferred.
  • Two to three years of experience working in a provider relations or customer service environment.
  • Effective communication skills, both written and verbal.
  • Computer literacy, especially Microsoft Office products.
  • Accuracy, attention to detail, and consistent follow-through.
  • Sensitivity to the health beliefs and needs of a multi-ethnic aged population.


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