Talent.com
Network Operations Coordinator
Network Operations CoordinatorIllinois Staffing • Springfield, IL, US
Network Operations Coordinator

Network Operations Coordinator

Illinois Staffing • Springfield, IL, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Network Operations Coordinator 3

Become a part of our caring community and help us put health first. 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. You will report to the Supervisor, Network Operations. As the Network Operations Coordinator 3, you will :

  • Manage data for health plans including demographics, rates, and contract intent.
  • Manage provider audits, provider service and relations, credentialing, and contract management systems.
  • Executes processes for intake and manage provider perceived service failures.

Use your skills to make an impact.

Required Qualifications

  • 2 or more years of experience working in a healthcare setting
  • Proficient in Microsoft Excel (ie formulas, filter, sort)
  • 1 or more years' Experience with in person or telephonic customer service skills
  • Preferred Qualifications

  • Experience with providers, payors, healthcare facilities, etc
  • Experience in Healthcare claims
  • Prior contract interpretation experience
  • Provider credentialling experience
  • Data analytic experience
  • Intermediate experience with Excel (pivot tables, formatting, v-lookup)
  • Hours 7am PST (8 hour shift) 5pm PST

    Additional Information

    HireVue : As part of our hiring process for this opportunity, we will be using an 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.

    Work at Home : To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria :

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees 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 employees 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.
  • Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

    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 and many other opportunities.

    Application Deadline : 02-04-2026

    About us Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

    Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.

    [job_alerts.create_a_job]

    Network Operations Coordinator • Springfield, IL, US

    [internal_linking.similar_jobs]
    RN - OR

    RN - OR

    Springfield Memorial Hospital - AYA • Springfield, IL, United States
    [job_card.full_time]
    Springfield Memorial Hospital - AYA.GetMed Staffing is searching for a strong OR RN to assist our traveler-friendly client. A minimum of 1-2 years of experience is required.Traveling with GetMed Sta...[show_more]
    [last_updated.last_updated_30] • [promoted]
    RN - TELE

    RN - TELE

    Memorial Medical Center • Springfield, IL, United States
    [job_card.permanent]
    Memorial Medical Center - Springfield.LiquidAgents Healthcare has several positions for RN, TELE at a healthcare facility in Springfield, IL. Job Duties : Administers high quality, skilled nursing ca...[show_more]
    [last_updated.last_updated_30] • [promoted]
    HP Field Operations Manager

    HP Field Operations Manager

    2020 Companies • Springfield, IL, United States
    [job_card.full_time]
    Companies has a full-time remote Field Operations Manager opportunity representing our client, HP.The Field Operations Manager plays a crucial role in ensuring the smooth operation of field activit...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Center Manager in Training - Relocation Required

    Center Manager in Training - Relocation Required

    Biolife Plasma Services • Springfield, IL, United States
    [job_card.full_time]
    By clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Tak...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Data Center Network Engineer

    Senior Data Center Network Engineer

    Match Point Solutions • Springfield, IL, United States
    [job_card.part_time]
    [filters_job_card.quick_apply]
    MatchPoint Solutions is a fast-growing, young, energetic global IT-Engineering services company with clients across the US . We provide technology solutions to various clients like...[show_more]
    [last_updated.last_updated_variable_days]
    Oncology Authorization Coordinator

    Oncology Authorization Coordinator

    Goodwin Recruiting • Springfield, IL, United States
    [job_card.full_time]
    Authorization Coordinator - Springfield, IL.Join a dedicated healthcare provider supporting patients in the Springfield area. This organization is known for its collaborative environment and commitm...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Hospitality Coordinator, Resy Support (West Coast)

    Hospitality Coordinator, Resy Support (West Coast)

    Illinois Staffing • Springfield, IL, US
    [job_card.full_time]
    At American Express, our culture is built on a 175-year history of innovation, shared values and Leadership Behaviors, and an unwavering commitment to back our customers, communities, and colleague...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Lead, Operations (Endo)

    Lead, Operations (Endo)

    Springfield Clinic • Springfield, IL, United States
    [job_card.full_time]
    The Operations Lead is responsible for training, support, and development of the Patient Concierge, PAS, and Call center team members. They assist in the daily oversight of front end, monitor, and t...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    IT Service Management Operations Lead

    IT Service Management Operations Lead

    ISC2 • Springfield, IL, United States
    [job_card.full_time]
    As the world's leading nonprofit member organization for cybersecurity professionals, our core values - Integrity, Advocacy, Commitment, Inclusion, and Excellence - drive everything we do in suppor...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Community Education Coordinator

    Community Education Coordinator

    Signet Health • Springfield, IL, US
    [job_card.full_time]
    Community Outreach Coordinator.Signet Health, a national behavioral health management company, is currently recruiting for a full-time Community Outreach Coordinator. The Community Outreach Coordina...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Revenue Operations Specialist

    Revenue Operations Specialist

    Dodge Construction Network • Springfield, IL, United States
    [job_card.full_time]
    Dodge Construction Network (Dodge) is experiencing growth and is on the lookout for a talented Revenue Operations Specialist to enhance our commercial organization. We need someone who is skilled in...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Area Operations Business Manager (Central)

    Area Operations Business Manager (Central)

    Edwards Lifesciences • Springfield, IL, United States
    [job_card.full_time]
    Make a meaningful difference to patients around the world.Driven by a passion to help patients live healthier and more productive lives, our Sales teams embrace Edwards Lifesciences’ values to buil...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Benefits Eligibility and Authorization Coordinator

    Benefits Eligibility and Authorization Coordinator

    Cardinal Health • Springfield, IL, United States
    [job_card.full_time]
    Benefits Eligibility and Authorization Coordinator.Contributions to Cardinal Health.The role of the Benefits Eligibility and Authorization Coordinator is vital in ensuring seamless operations withi...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Authorization Coordinator

    Authorization Coordinator

    Radiation Business Solutions • Springfield, IL, United States
    [job_card.full_time]
    The Authorization Coordinator will be responsible for effectively acquiring Radiation Oncology authorizations, working denied authorizations and submitting appeals as needed.The Authorization Coord...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Area Coordinator

    Area Coordinator

    University of Illinois Springfield, IL • Springfield, IL, US
    [job_card.full_time]
    About UIS : Located in the state capital, the University of Illinois Springfield is one of three members of the University of Illinois system. The University serves more than 4,000 students in 44 gra...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Breakfast Coordinator

    Breakfast Coordinator

    Carrols Restaurant Group • Springfield, IL, US
    [job_card.full_time]
    Carrols Restaurant Group - 510 W Jefferson St [Restaurant Shift Supervisor] As a Breakfast Coordinator at Carrols Restaurant Group, you'll : Ensure that the store is delivering excellent guest servi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Social Media Coordinator - Remote

    Social Media Coordinator - Remote

    TradeJobsWorkForce • 62563 Rochester, IL, US
    [filters.remote]
    [job_card.full_time]
    Social Media Coordinator Job Duties : Execute a results-driven social media strategy.Develop and curate engagin...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Associate Intake Coordinator

    Associate Intake Coordinator

    Highmark Health • Springfield, IL, United States
    [job_card.full_time]
    This job is responsible for completing all Prior Authorization outbound call tasks and / or inbound triage case creations. In compliance with regulatory guidelines (e.NCQA, CMS), the incumbent informs...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]