Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off
Network Operations Coordinator 3
Location
USA Timezones + 1 moreAll locations: USA Timezones | EST (UTC-5)
Posted
41 days ago
Salary
$44.9K - $60.2K / year
Seniority
Mid Level
No structured requirement data.
Job Description
Network Operations Coordinator 3
Humana
Role Description The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. This role performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. The Network Operations Coordinator 3 manages provider data for health plans including but not limited to: - Demographics - Rates - Contract intent Additional responsibilities include: - Managing provider audits - Provider service and relations - Credentialing - Contract management systems - Executing processes for intake and managing provider perceived service failures Decisions are typically focused on methods, tactics, and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes, and techniques, and works under limited guidance due to previous experience and breadth and depth of knowledge of administrative processes and organizational knowledge. Qualifications - Minimum of 2 years of provider relations experience, provider data, provider reporting, and/or provider support - Prior healthcare credentialing experience - Experience with CRM - Intermediate in Microsoft Word and Excel Requirements - Provider contract interpretation experience - Familiar with Medicare/Medicaid - Previous account management or project management - Knowledge of medical claims and terminology - Ancillary facility or FQHC/RHC experience - Experience working with one or more of the following: APEX, PMDM, PAAG Benefits - Benefits starting day 1 of employment - Competitive 401k match - Generous Paid Time Off accrual - Tuition Reimbursement - Parent Leave Work at Home Requirements - Minimum download speed of 25 Mbps and upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular, and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $44,900 - $60,200 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides: - Medical, dental and vision benefits - 401(k) retirement savings plan - Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) - Short-term and long-term disability - Life insurance - Many other opportunities Application Deadline 05-08-2026
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