Operations & Provider Relations Coordinator (HIPAA experience)

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.

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

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