Insurance Operations Coordinator

3 weeks ago


Torrance, United States HireTalent - Diversity Staffing & Recruiting Firm Full time

Insurance Operations Coordinator

Torrance, CA

Contract-to-hire


The Insurance Network Operations Coordinator 2 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations.


Must Haves:

  • Less than 3 years of technical experience
  • Previous account management, project management or related experience
  • Associates or Bachelors' Degree
  • Prior experience working in the insurance industry

Preferred:

  • Prior contract interpretation experience strongly desired
  • MS Access
  • Previous provider experience (provider contract, provider relations, or provider service)
  • Previous experience in claims

Key Responsibilities & Actions:

  • Manages provider data for health plans including but not limited to demographics, rates, and contract intent
  • Manages provider audits, provider service and relations, credentialing, and contract management systems.
  • Executes processes for intake and manage provider perceived service failures, decisions are typically focused on interpretation of area/department policy and methods for completing assignments
  • Performs varied activities and moderately complex administrative/operational/customer support assignments.
  • Performs computations.
  • Typically works on semi-routine assignments.
  • Manages provider data for health plans including but not limited to demographics, rates, and contract intent.
  • Manages provider audits, provider service and relations, credentialing, and contract management systems.
  • Executes processes for intake and manage provider perceived service failures.
  • Decisions are typically focus on interpretation of area/department policy and methods for completing assignments.
  • Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
  • Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.


Required Qualifications

  • Less than 3 years of technical experience
  • Proficiency in MS Office applications
  • Possess a strong attention to detail
  • Ability to work in a deadline driven environment
  • Strong verbal and written communication skills
  • Previous account management, project management or related experience
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications

  • Associates or Bachelors Degree
  • Prior experience working in the insurance industry
  • Proficiency in MS Access
  • Previous experience in claims
  • Prior contract interpretation experience strongly desired
  • Previous provider experience (provider contract, provider relations, or provider service

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