Network Operations Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Play a crucial behind-the-scenes role in assisting the Provider Relations team and the NIOSH World Trade Center Health Program.

• Concentrate on ensuring provider network data is accurate, executing timely data entry and updates, analyzing information for trends or inconsistencies, and aiding in the completeness, organization, and reliability of provider records and documentation.

• Manage provider network data across various tracking reports, systems, and internal data sources, guaranteeing that records are precise, complete, and up-to-date.

• Conduct high-volume data entry, data validation, and record maintenance concerning provider demographics, enrollment documentation, contract status, and other network details.

• Examine provider data for accuracy, consistency, duplicates, missing information, and potential discrepancies; investigate issues and coordinate corrections through established processes.

• Prepare, update, and analyze reports to support provider network operations, identify trends, monitor pending items, and assist the team in prioritizing follow-up tasks.

• Facilitate the secure exchange, tracking, and organized management of provider enrollment and network documentation in compliance with program requirements and internal procedures.

• Assist with incoming internal requests, shared mailbox items, ServiceNow tickets, and escalated operational inquiries by researching information, updating records, and routing items accordingly.

• Collaborate with internal stakeholders to ensure timely resolution of provider data issues, claims-related research, grievances, compliance reviews, and other operational needs.

• Adhere to standard operating procedures, maintain precise documentation of completed work, and propose process enhancements to bolster data integrity and team efficiency.

⛳️ Requirements

• Bachelor’s degree preferred; an equivalent combination of education and relevant experience is acceptable.

• 2–5 years of experience in healthcare operations, provider network operations, provider data management, claims support, enrollment, credentialing support, or a similar back-office healthcare environment.

• Proficient data entry, data validation, and record maintenance abilities, demonstrating a strong commitment to accuracy, completeness, and confidentiality.

• Proficient in Microsoft Excel, including sorting/filtering, basic formulas, formatting, data cleanup, and comparison of information across multiple data sources; intermediate Excel skills are preferred.

• Experience with multiple systems or databases and a willingness to learn new applications, workflows, and reporting tools.

• Ability to analyze information, identify patterns or discrepancies, investigate root causes, and support practical solutions.

• Exceptional attention to detail, organization, follow-through, and capacity to manage recurring tasks, competing priorities, and deadlines.

• Professional written communication skills and the ability to collaborate effectively with internal and cross-functional partners.

• Familiarity with HIPAA, protected health information, provider enrollment, claims, credentialing, ServiceNow, or provider data systems is advantageous but not mandatory.

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plan with company matching.

• Opportunities for professional development and growth.

• Flexible working hours and remote work options.

• Supportive and collaborative work environment.