Provider Administrator

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. 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.

Our client, a leading Insurance Company is looking for Provider Administrator and This is for an initial duration of 06 MonthsContract – 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.