Provider Network Specialist

About This Role

The Provider Network Specialist supports provider network operations by ensuring accurate provider records, timely credentialing, and effective communication between internal teams and external providers. This role involves a wide range of administrative tasks related to provider enrollment, data maintenance, and contract administration.

Responsibilities

• Perform provider enrollment and maintain accurate provider records
• Assign provider numbers and support credentialing processes
• Prepare, process, and track provider-related documentation and correspondence
• Maintain detailed documentation of all actions and communications
• Support provider contract administration and data updates
• Communicate professionally with providers and internal teams
• Identify issues, problem-solve, and escalate when appropriate
• Ensure compliance with established policies and procedures

Requirements

• High School Diploma or General Equivalency Diploma
• 2+ years of operations support experience related to provider networking, claims processing, customer service, or membership enrollment
• Proficiency with Microsoft Office Suite, including Word and Excel
• Strong attention to detail and organizational skills
• Ability to work independently and take initiative
• Excellent written and verbal communication skills

Qualifications

• High School Diploma or General Equivalency Diploma required
• Minimum of two (2) years of operations support experience related to provider networking, claims processing, customer service, membership enrollment, or a related field

Skills

* Required skills