Network Operations Coordinator I

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. 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 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. Written and verbal communication skills to interact with internal and external customers

• 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.
• 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.

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. 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. 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. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.