Provider Administrator

Our client, a leading Insurance Company is looking for Provider Administrator and This is for an initial duration of 06 Months Contract - Remote Role

Job Title: Provider Administrator

Job Id: 26-04534

Location: Remote Role

Duration: 06 Months Contract

Position Type: Hourly Contract Position (W2 only)

• Remote - Flex but available between 6 am PST to 5pm PST
• Must have Salesforce and excel experience, strong attention to detail, and be able to communicate and collaborate with teams.
• Heavy casework through Salesforce and heavy email base, not much calling to providers.

TECHNICAL SKILLS

Must Have

• Salesforce
• Sharepoint

Nice To Have

• Microsoft Teams

Job Description

• Under direct supervision, work within and across department teams to manage provider and office staff service requests, resolve business partner questions/issues and provide call handling/routing to provider support line.
• Support provider management activities associated with provider data maintenance, credentialing activities, directory management and intake requests.
• Research, resolve, document and accurately respond to provider, practice, business parter or administor inquires and service requests.
• Communicate and coordinate with providers, practices and other departments to ensure accurate information is available to support business needs.
• Manage the Committee meetings set up, document Committee findings in the formal meeting minutes and notify staff of Committee decisions.
• Monitor and maintain critical provider information in various systems.
• Review team member quality assurance reports on a regular basis and working with leadership to prepare follow-up documentation.
• Act as first-level intake and triage for incoming provider call line, data clean-up efforts and specified team email box requests. Support the client and regulatory audit process to include pulling required documentation and review of provider files for accuracy.
• Gain industry knowledge to support internal and external business partner relationships. Support the recredentialing process and audit support functions to NCQA and client standards.
• Ensure requested information is delivered within specified timeframe and completed accurately. Maintain high standards in all written or verbal communications with providers.

Job Specifications

• Typically has the following skills or abilities:
• Two to four years of general office experience
• Proficient with word and spreadsheet applications
• Ability to read and write at a level necessary to accomplish the above tasks
• Demonstrated ability to identify problems and provide creative solutions
• Strong attention to detail, organizational skills and problem solving skills Excellent written and verbal communication skills Ability to work independently and in a team environment
• For roles that are remote (i.e., Work From Home (WFM)) or hybrid (i.e., partial onsite at a Client location and WFM), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment

Compensation: The hourly rate for this position is between $25.00-$27.00 per hour.

Factors which may affect starting pay within this range may include [geography/market, skills, education, experience and other qualifications of the successful candidate].

Benefits: Sunrise offers ACA compliant medical coverage/dental insurance/vision insurance to all employees. We also offer Sick time benefits as required per State regulations.

Qualified candidates please send your word format updated resume at the earliest to Pavan: Pavan.p@sunrisesys.com [732-395-4444].

Thank You.