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Capital Blue Cross · 1 day ago

Provider Network Operations Support Coordinator

Harrisburg, PA

Full-time

Onsite

Mid Level

3+ years exp

Capital Blue Cross is dedicated to improving the health and well-being of its members and communities. The Provider Network Operations Support Coordinator will be responsible for day-to-day support in Network Operations, including managing vendor invoicing, analyzing service agreements, and supporting provider data verification and regulatory compliance.

ConsultingHealth CareHealth InsuranceProfessional Services

H1B Sponsor Likely

Responsibilities

Identify and execute all department changes as the Access Coordinator

Conduct provider outreach phone calls to support ongoing NCQA and other regulatory requirements related to provider access and availability surveys

Conduct provider outreach phone calls to support provider attestation to stay in compliance with state and federal regulations

Update/Modify department policies and procedures as needed

Update/Modify all user guides for both internal and external facing training tools

Serves as a point of contact for department for requests for information. Prioritizes requests

Review claims data to determine opportunities for additional savings

Vendor relationships: Maintain issues logs and ensures appropriate staff are engaged with vendor activities and follow through on resolution of issues. Acts as primary point of contact with contract issues with vendors. Monitor vendors’ performance to contract including performance guarantees and service levels. Acts as liaison with vendor and Network Operations

Process all vendor invoicing and balance to budget. Track vendor invoicing against claims processed and budget

Review processed claims to determine opportunities for additional savings

Participates in special projects as assigned. May involve reviewing data concerning issues affecting department functions and operations

Other duties assigned by the Manager

Qualification

Analytical skillsVendor managementCommunication skillsFinancial reportingOffice proceduresBasic mathematicsEnglish language proficiencyProblem solvingTime managementInitiative

Required

3 years' experience in an office setting support position

High school diploma or GED

Strong verbal and written communication skills

Ability to apply sound business judgment in making decisions that affect the Plan

Demonstrated strong analytical and problem solving skills

Ability to prepare and use financial and other reports and interpret results

Ability to meet deadlines and manage multiple priorities

Ability to demonstrate initiative and act independently in resolving issues

Knowledge of the English language, especially spelling, punctuation and grammar

Standard office practice and procedures including appropriate form and format of business correspondence and reports

Basic mathematics and the ability to balance budget reporting

Benefits

Medical, Dental & Vision coverage

Retirement Plan

Generous time off including Paid Time Off, Holidays, and Volunteer time off

Incentive Plan

Tuition Reimbursement

Company

Capital Blue Cross

At Capital Blue Cross, we promise to go the extra mile for our team and our community.

Founded in 1938

Harrisburg, Pennsylvania, USA

1001-5000 employees

https://capbluecross.com

H1B Sponsorship

Capital Blue Cross has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (4)

2024 (13)

2023 (5)

2022 (9)

2021 (5)

2020 (5)