Insurance Provider Operations Coordinator
Insurance Provider Operations Coordinator
University Health System
San Antonio, Texas
As the only locally owned and managed, non-profit health plan in the area, Community First Health Plan’s commitment to our members is to provide great health care benefits backed by outstanding service
For over 20 years now, Community First has provided quality health care and has touched the lives of almost 700,000 unique individuals. Community First is NCQA-accredited (National Committee for Quality Assurance.
Position Summary
The Insurance Provider Operations Coordinator is responsible for the recruitment, training and management of all provider types to ensure network is adequate and meets appropriate access/appointment availability. The Coordinator interfaces with various departments to resolve provider issues related to service delivery, authorization and access/appointment availability. Coordinator will facilitate and monitor participation in provider incentive programs, service delivery improvement activities and will conduct audits to ensure compliance.
The Specialist will be required knowledge of Regulatory Deliverables from Health and Human Services Commission (HHSC) and Texas Department of Insurance (TDI). Knowledge of Microsoft Excel is critical, as is Power Point and Reporting Capabilities.
EDUCATION/EXPERIENCE
A minimum of five years of experience in managed health care delivery or managed care operations is required.
Must have knowledge of regulatory deliverables from Health and Human Services Commission (HHSC) and the Texas Department of Insurance (TDI).
Candidate should have experience with assisting providers with credentialing and claims issues.
Apply with CV or resume
EOE