Network Operations Coordinator I

Job Summary This position is responsible for the contracting, credentialing, and maintenance of Professional Provider Data to support Marketing, Membership and Network Contracting across all lines of business. This includes providing accurate and timely administration of provider contracts, rosters and requests supporting quality initiatives to ensure data accuracy. Responsibilities Responsibilities including internal provider meetings and work groups, researching problems related to provider credentialing, data and network participation. Includes working as a Liaison between Network Contracting and Provider Data Management for credentialing and network activities. Required Job Qualifications 2 years of college OR two years of experience Written and verbal communication skills to interact with internal and external customers Analytical and quantitative skills Ability to take initiative and work independently Preferred Job Qualifications Experience working directly with healthcare providers and provider offices to obtain information, resolve issues, and support business operations. 1 year of experience on the Premier Provider Data systems. Existing knowledge of Professional Provider Credentialing processes. Experience supporting Affordable Care Act (ACA) Risk Adjustment Data Validation (RADV) activities, medical record retrieval, audit support, or related initiatives. Claims processing, claims research, or claims resolution experience within a healthcare or health plan environment. Strong investigative and problem-solving skills with the ability to research discrepancies, gather information, and drive issues to resolution. Experience working in a high-volume call center or customer service environment, preferably handling provider or claims-related inquiries. Ability to work independently, take initiative, and effectively manage a high-volume workload with minimal supervision. Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances. Base Pay Range $40,500.00 - $72,500.00 Exact compensation may vary based on skills, experience, and location. HCSC Employment Statement We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at View phone number on click.appcast.io to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Company Overview For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved. #J-18808-Ljbffr Health Care Service Corp.