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