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Randstad USA

Member and Provider Operations Specialist

Job Description

member and provider operations specialist .farmington, missouriposted today job detailssummary$22
  • $23 per hourtemp to permhigh schoolcategoryoffice and administrative support occupations reference AB_5064564 job details Our client is looking for an organized and efficient Member & Provider Operations Specialist to oversee key health plan administration tasks.
In this position, you will maintain data integrity across member accounts, facilitate seamless provider transitions, and manage initial claim submissions. Your accuracy will ensure our members maintain uninterrupted access to quality care and support overall operational workflows.
MUST BE LOCATED NEAR FARMINGTON, MO
  • THIS ROLE IS ONSITEsalary:
    $22
  • $23 per hourshift: Firstwork hours: 8 AM
  • 5
PMeducation:
High SchoolResponsibilities Manage incoming system tickets and online portal submissions regarding updates to member files and primary physician p reference updates promptly and with high precision. Reassign affected patient panels and trigger official notification mailings following practitioner network departures. Handle complex primary care assignments by hand whenever automated enrollment rules are unable to complete the match. Audit customer service representative activity to identify, log, and report doctor assignment mistakes to improve quality control. Collect, review, and resolve undelivered mail items to ensure accurate contact information and communication records. Review and adjudicate initial claim submissions generated by network practitioners and plan subscribers. SkillsEntering DataExcelProvider DataTime ManagementTyping 50 WPM (1 year of experience is required)ClaimsHealthcare (2 years of experience is required)QualificationsYears of experience: 2 yearsExperience level: ExperiencedRandstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer:
Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days.

Benefits

  • 401(k) Plans
  • Dental Insurance
  • Disability Insurance
  • Life Insurance

Career Insights for Scheduler / Operations Coordinator

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What they do

A Scheduler or Operations Coordinator provides scheduling and logistical support for an office, company or organization. May specialize in scheduling required for production or for administrative work.

$53,595 / year median in Missouri

+9% projected growth

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