Provider Network Configuration Specialist

Description

Under direct supervision, work within and across department teams to maintain the configuration of providers, locations, groups, plans, and benefit limits in the managing system. Ensure accurate and timely completion of production tickets assigned to ensure client satisfaction and retention. Support provider management activities associated with provider data maintenance, credentialing activities, directory management, and intake requests.

Essential Functions

Research, resolve, document, and accurately respond to provider, practice, business partner, or administrator inquiries and service requests

Communicate and coordinate with providers, practices, and other departments to ensure accurate information is available to support business needs

Add and update Benefits Limits, Groups, Plans, new providers, and new locations in system

Upload fee schedules to applicable systems

Responsible for accurate setup of direct deposits

Configure and provide appropriate web portal access to clients

Timely and accurately generate and deliver reports as requested

Responsible for new business configuration setups following established processes/protocols

Ensure requested information is delivered within the specified timeframe and completed accurately

Maintain high standards in all written or verbal communications with providers

Requirements

Job Specifications

Typically has the following skills or abilities:

Two years of experience in health insurance information and data management systems

Strong understanding of health plan terminology

Computer proficiency, including Microsoft Excel and other MS Office tools

Strong analytical and critical thinking skills

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

Highly motivated and reliable individual with a strong sense of urgency; ability to meet tight deadlines

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 (WFH)) or hybrid (i.e., partial onsite at a VSP location and WFH), must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment

VSP Vision is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, disability, or protected veteran status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here.