ROLE SUMMARY

Our client is seeking a highly organized and service-oriented Operations and Provider Relations Coordinator who will support both the operations and provider relations teams of the company. This hybrid role is ideal for someone who thrives in a fast-paced, remote environment and enjoys both back-office administrative tasks and external provider engagement.

This individual will play a critical part in maintaining operational flow through documentation, quality assurance, and internal coordination, while also managing key elements of the attorney network, including recruitment, credentialing, and ongoing communication. Strong communication, autonomy, and time management skills are essential.

WORK SCHEDULE: 9:00 AM – 6:00 PM Mountain Daylight Time (11:00 PM – 8:00 AM Philippine Standard Time), follows Philippine holidays

POSITION TYPE: Full Time

WORK ARRANGEMENT: Remote

ESSENTIAL FUNCTIONS:

• Perform the following operations support-related responsibilities (approximately 60% of the job):
• Respond to client and provider emails regarding benefit inquiries and authorizations
• Complete digital intakes and follow up on QA tasks, including chart reviews and authorization reviews
• Maintain accurate documentation across systems in compliance with HIPAA standards
• Manage incoming and outgoing email, forms, and faxes efficiently
• Participate in internal quality assurance processes, providing constructive feedback to team members
• Support case management by coordinating resources and ensuring smooth handoffs
• Perform the following provider relations support-related tasks (approximately 40% of the job):
• Assist in recruiting attorneys to join the provider network or complete single-case agreements
• Maintain accurate and up-to-date records in Microsoft 365
• Review and manage attorney applications, ensuring credentialing requirements are met
• Re-credential existing attorneys and follow up to ensure data integrity
• Serve as a point of contact for attorneys, handling questions related to IT, contracts, payments, and more
• Review, revise, and support contract negotiations and rate discussions under guidance from management
• Resolve complaints or concerns about attorneys with professionalism and discretion
• Ensure quality assurance standards are consistently met in provider-related workflows
• Facilitate smooth communication between internal departments and external partners

QUALIFICATIONS:

• Bachelor’s degree required
• Working knowledge of HIPAA and handling confidential health information
• Demonstrates high standards of professionalism, confidentiality, and adherence to HIPAA, HITECH, and internal policies
• Strong computer literacy with proficiency in Microsoft 365 (Outlook, SharePoint, Teams, Forms)
• Experience with EHR or CRM systems preferred (please specify)
• Excellent communication and interpersonal skills, with the ability to engage with diverse individuals and communication styles
• Highly organized and can manage multiple priorities in a fast-paced, remote environment.
• Self-motivated, adaptable, and capable of working both independently and collaboratively
• Maintains professionalism, calmness, and positivity under pressure
• Responds to calls and emails promptly and professionally
• Flexible and open to evolving responsibilities and company needs
• Actively contributes to continuous improvement and fosters respectful, solutions-oriented collaboration

Please refer to job description.