[Hiring] Provider Administrator @Sunrise Systems

Role Description

Our client, a leading Insurance Company, is looking for a Provider Administrator for an initial duration of 06 Months Contract – Remote Role.

• Job Title: Provider Administrator
• Job Id: 26-04534
• Location: Remote Role
• Duration: 06 Months Contract
• Position Type: Hourly Contract Position (W2 only)
• Remote - Flex but available between 6 am PST to 5 pm PST

Must have Salesforce and Excel experience, strong attention to detail, and be able to communicate and collaborate with teams.

Heavy casework through Salesforce and heavy email base, not much calling to providers.

Technical Skills

• Must Have: Salesforce, Sharepoint
• Nice To Have: Microsoft Teams

Under direct supervision, work within and across department teams to:

• Manage provider and office staff service requests.
• Resolve business partner questions/issues.
• Provide call handling/routing to provider support line.
• Support provider management activities associated with provider data maintenance, credentialing activities, directory management, and intake requests.
• Research, resolve, document, and accurately respond to provider, practice, business partner, or administrator inquiries and service requests.
• Communicate and coordinate with providers, practices, and other departments to ensure accurate information is available to support business needs.
• Manage the Committee meetings setup, document Committee findings in formal meeting minutes, and notify staff of Committee decisions.
• Monitor and maintain critical provider information in various systems.
• Review team member quality assurance reports regularly and work with leadership to prepare follow-up documentation.
• Act as first-level intake and triage for incoming provider call line, data clean-up efforts, and specified team email box requests.
• Support the client and regulatory audit process, including pulling required documentation and reviewing provider files for accuracy.
• Gain industry knowledge to support internal and external business partner relationships.
• Support the recredentialing process and audit support functions to NCQA and client standards.
• Ensure requested information is delivered within specified timeframe and completed accurately.
• Maintain high standards in all written or verbal communications with providers.

Qualifications

• Two to four years of general office experience.
• Proficient with word and spreadsheet applications.
• Ability to read and write at a level necessary to accomplish the above tasks.
• Demonstrated ability to identify problems and provide creative solutions.
• Strong attention to detail, organizational skills, and problem-solving skills.
• Excellent written and verbal communication skills.
• Ability to work independently and in a team environment.
• For remote or hybrid roles, must demonstrate a high level of engagement in virtual environments, including maintaining camera presence during meetings to support effective communication and team alignment.

Compensation

The hourly rate for this position is between $25.00-$27.00 per hour. Factors which may affect starting pay within this range may include geography/market, skills, education, experience, and other qualifications of the successful candidate.

Benefits

• Sunrise offers ACA compliant medical coverage, dental insurance, and vision insurance to all employees.
• We also offer sick time benefits as required per State regulations.

Application Process

Qualified candidates please send your word format updated resume at the earliest to Pavan: [email protected] or call 732-395-4444 .