Provider Operations Support Specialist

PROVIDER OPERATIONS SUPPORT SPECIALIST

The Provider Operations Support Specialist provides day-to-day administrative and systems support to the Provider Operations team by assisting with provider credentialing activities provider data maintenance reporting and member notification of network changes. This role supports Provider Operations Coordinators by executing defined workflows maintaining accurate provider records tracking documentation and completing health plan reporting to ensure compliance with client and Health Plan requirements.

What youll be doing

• Assisting with provider credentialing by collecting documentation entering provider data submitting required materials to the health plan tracking completion and updating internal records.
• Maintaining and updating provider records from various sources in internal systems to ensure accuracy and completeness.
• Supporting reporting requirements including completing health plan reports on assigned schedules.
• Preparing and processing member notifications related to provider network changes.
• Supporting website activations and updates for provider directories.
• Performing internal macro audits to validate data accuracy and record completeness.
• Following established workflows and procedures escalating issues to Provider Operations Coordinators as needed.
• Completing additional administrative and operational support tasks for the Provider Operations team.

Qualifications :

Qualifications

What youll need for success:

12 years of experience in healthcare managed care or provider network operations including provider records credentialing or administrative support.

• Strong technical aptitude with the ability to quickly learn new systems tools and workflows.
• High attention to detail and strong organizational skills in a compliance-driven environment.
• Comfort working with structured data data entry and reports with an understanding of data accuracy and integrity.
• Ability to manage multiple priorities and meet deadlines in a fast-paced evolving environment.
• Working knowledge of Microsoft Office with strong Excel skills (data entry basic formulas data validation); Access a plus.
• Analytical and problem-solving skills with the ability to recognize patterns errors and opportunities for improvement.
• Ability to work independently on assigned tasks while collaborating with a team and escalating issues appropriately.
• Strong written and verbal communication skills with a professional service-oriented approach.

Additional Information :

All your information will be kept confidential according to EEO guidelines.

ALIVE with Purpose: How We Thrive at Guidehealth 

At Guidehealth our values come to life in everything we do. 

• We are Driven by Accountability grounded in transparency reliability and integrity as we navigate challenges and opportunities alike. 
• Always Growing Always Learning staying curious and continuously improving inspires us to shape a better future for healthcare. 
• With Collaborative Innovation we solve problems creatively making every experience better for our employees and the patients we serve. 
• At Guidehealth Every Voice Matters we believe our collective strength is rooted in the unique perspectives of each team member. 
• And through Empathy in Action we build stronger connections with those who count on us. 
• This is what it means to be ALIVE with purpose. This is how we thrive together at Guidehealth. 

BENEFITS:

While you are hard at work advancing value-based healthcare we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical Dental and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those just in case moments. Additionally we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.

COMPENSATION:

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include but are not limited to: skill set years of relevant experience education location and licensure/certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT 

Diversity inclusion and belonging are at the core of Guidehealths values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race religious creed color age sex sexual orientation and identity national origin citizenship religion marital status familial status physical sensory or medical disability Family and Medical Leave military or veteran status pregnancy childbirth or other related medical conditions or any other classification protected by federal state and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring placement promotion transfer demotion layoff termination recruitment advertising pay and other forms of compensation training and general treatment during employment. 

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealths custodianship as well as Guidehealth Intellectual Properties.  For any security-specific roles the responsibilities would be further defined by the hiring manager. 

As a remote-first organization handling sensitive healthcare data Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy data security and compliance requirements.

REMOTE WORK TECHNICAL REQUIREMENTS

Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements. 

Remote Work :

Yes

Employment Type :

Full-time