Prov Network Coordinator

Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded managed health care companies. Health Net's mission is to help people be healthy, secure and comfortable. The company's POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company's Web site at www.healthnet.com


JOB SUMMARY:


Provides assistance to the Provider Services Representative, Senior Contract Negotiators and Management; researches and resolves provider issues; performs related work as required or assigned.


ESSENTIAL DUTIES AND RESPONSIBILITIES:

First point of contact for Provider inquiries, including Provider contracts status, claim issues, demographic updates, complaints or concerns.
Manages and promotes Provider satisfaction through ensuring proactive service, support and education.
Creates Excel spreadsheets to monitor and track contracts, including reconstructing current Providers, to ensure timely and accurate implementation.
Ensures that appropriate reference materials and Health Plan protocols are current and consistent.
Receives and processes the monthly credentialing report including verification of the credentialing report, updating of contract tracking log, and assembly of new Provider packets.
Monitoring and tracking of site visit tool and in-service log.
Actively identifies opportunities for process improvement and communicates best practices to improve overall efficiency.
Coordinates and maintains all educational materials for use and distribution to the Provider community.
Assist with special projects as needed.
REQUIREMENTS
REQUIREMENTS:


Education:
High School Diploma or GED


Certification/License:


Experience:

Two years experience in a professional environment; health care/insurance environment preferred.

Two years general administrative experience

Good oral and written communication skills

Knowledge of HMO, PPO, Medicare Risk and Indemnity products preferred

Claims experience helpful.


Knowledge, Skills & Abilities:
Good oral and written communication skills required, with strong emphasis on customer service and administrative skills.Knowledge of HMO,PPO, Medicare Risk and Indemnity products preferred.Excellent data entry skills.Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.


Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.


Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.