Network Provider Information Specialist

Join us for an exciting career with the leading provider of supplemental benefits!

Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

The Network Provider Information Specialist is responsible for managing and maintaining accurate and up-to-date provider information within the healthcare network. This includes supporting the provider enrollment, credentialing, and data entry processes, as well as ensuring compliance with regulatory requirements. The specialist works closely with internal teams, such as network development, provider relations, claims, and customer service, to address provider-related inquiries and resolve issues. They contribute to the overall efficiency of the provider network. This role requires strong attention to detail, effective communication skills, and the ability to handle multiple tasks in a fast-paced environment while ensuring the accuracy and integrity of provider data.

Scope: 

In this role you as a Network Provider Information Specialist, you will play a critical role in ensuring the accuracy, integrity, and timely management of provider data. This position is responsible for maintaining comprehensive records of healthcare providers, supporting the provider credentialing and enrollment processes, and collaborating with internal teams to address provider-related inquiries. The specialist ensures that the provider network is up-to-date, compliant with regulations, and aligned with organizational goals. Additionally, they contribute to system maintenance and the resolution of issues, playing an essential part in the smooth functioning of the network management system.

The Network Provider Information Management team performs data entry of providers into Avesis systems. This includes gathering, maintaining, and managing accurate information about dental and vision providers. This team is integral to the accuracy of our provider directory and claims processing.

Avēsis is an ancillary insurance company that guides members and communities to wellness through

innovative, multidimensional, tailored offerings, delivered with a personal touch. We envision a world

where lives are lived more fully, communities are healthier, and futures are brighter for all. To be

successful at Avēsis, we perform at a high level everyday while remaining humble, helpful and positive.

Our high expectations are not for everyone. But for those of us who deeply care about the human

condition and have a passion to improve lives, this is a place to thrive.

Competencies: –

Functional:

• Data Management & Accuracy: Ability to maintain and update provider data with a high level of accuracy, ensuring data integrity.
• Healthcare Industry Knowledge: Understanding of healthcare networks, credentialing, insurance plans, and regulatory compliance requirements.
• System Proficiency: Skilled in using network management software and databases to manage and update provider information.
• Communication & Interpersonal Skills: Effective communication with internal teams.
• Problem-Solving & Critical Thinking: Ability to identify and resolve provider information issues in a timely and efficient manner.
• Attention to Detail: Ensuring accuracy by thoroughly reviewing and verifying provider data and documentation.
• Customer Service Orientation: Providing timely and professional assistance to providers and internal teams to resolve inquiries and issues.
• Time Management: Ability to manage tasks and projects effectively, ensuring deadlines and quality standards are met.
• Monitoring Incoming Notifications: Proactively monitor incoming notifications related to provider updates, changes, or compliance requirements.
• Specialty Fee Schedules: Accurately enter and update specialty fee schedules into the provider management system based on incoming data.

Core:

• Attention to Detail: Demonstrates a high level of accuracy and thoroughness in managing provider data, ensuring all records are correct and up to date.
• Organizational Skills: Ability to effectively manage multiple tasks and prioritize responsibilities to meet deadlines and maintain workflow efficiency.
• Communication Skills: Strong written and verbal communication skills to collaborate effectively with internal teams.
• Problem-Solving Abilities: Capable of identifying issues, analyzing root causes, and implementing effective solutions quickly and efficiently.
• Team Collaboration: Works effectively within cross-functional teams, contributing to the success of the organization by collaborating with various stakeholders.
• Adaptability: Flexible and responsive to changing priorities, processes, and regulations in a dynamic work environment.
• Task Organization: Manages time effectively to ensure tasks are completed on schedule while maintaining a high standard of work quality.
• Technical Proficiency: Comfortable working with provider management systems and software tools to efficiently enter and manage data.
• Compliance Awareness: Understanding of and adherence to healthcare industry regulations and policies, ensuring all provider data management processes comply with applicable standards.

Behavioral:

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth. 
• Initiative: readiness to lead or take action to achieve goals.
• Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
• Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
• Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
• Flexible and responsive:  managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
• Integrity & responsibility:  acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Minimum Qualifications:

• High school diploma or equivalent required.
• At least 1-2 years of experience in a healthcare setting, preferably in provider relations, network management, or claims processing.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• High level of accuracy and attention to detail in managing provider data and documentation.
• Ability to manage multiple tasks simultaneously while meeting deadlines.
• Basic understanding of healthcare insurance plans, provider networks, and credentialing processes.
• As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.

Preferred Qualifications:

• Associate’s degree in healthcare administration, business, information technology, or a related field.
• Familiarity with provider management systems, database software, or other related platforms.
• Knowledge of industry regulations (e.g., HIPAA, CMS guidelines).

We Offer

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

Equal Employment Opportunity

At Avēsis, We See You.  We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic.  At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients.  We focus on recruiting, training and retaining those individuals that share similar goals.  Come Dare to be Different at Avēsis, where We See You!