Provider Network Representative

Company: Volt
Location: Albuquerque
Posted on: April 24, 2025

Job Description:

Hi Sir,

Apply below after reading through all the details and supporting information regarding this job opportunity.

Innova Solutions has a client that is immediately hiring for a Provider Network Representative

Position type: Fulltime/Contract
Job Title: Provider Network Representative
Location: Albuquerque, New Mexico
Work Mode: (Hybrid - 3 days onsite, 2 days remote)
Duration: 6 months

As a Provider Network Representative, You will
Job Description:

The Provider Network Representative is responsible for supporting the provider network, including assisting with claims, pricing, contracts, and provider relationships. The role involves a variety of tasks related to problem resolution, training, reporting, and communication with internal and external stakeholders.

Key Responsibilities:
Provider Support & Problem Resolution: Assist practitioners in resolving issues related to claims, pricing, contracts, and relationships. Ensure smooth operations of network relationships and maintain accurate records of activities.
Training & Education: Provide training to provider staff on operational procedures and policy updates. Develop training materials as necessary.
Reporting & Documentation: Submit regular reports on provider service and recruitment activities. Create and maintain reports on managed care networks and provider data.
Fee Requests & Coordination: Respond to provider fee requests and assist in resolving systemic problems and claims issues.
Provider Directory & Database Management: Review provider directories, maintain databases, and ensure accuracy in provider information.
Relationship Management: Build and maintain relationships with key stakeholders, including facilities, physician groups, practice managers, and internal departments.
Compliance & Confidentiality: Comply with all corporate policies, including HIPAA and Diversity Principles. Maintain confidentiality in all aspects of the business.
Special Projects: Assist management with special projects and reporting requirements as needed.

Job Requirements:
Education: Bachelor's degree or 4 years of work experience in the healthcare/insurance industry.
Experience:3 years in Network Management, Credentialing, and/or Customer Service.
Familiarity with health care contracts, applications, products, and claims processing systems.
Experience with PC usage for at least 3 years.


Skills:Understanding of provider reimbursement methods.
Strong communication skills, customer service focus, and proficiency in Excel.
Knowledge of MCO (Managed Care Organization) experience is a plus.




Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.
We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.

Thank you!
Anshima Chachondia
Associate - Recruitment
anshima.chachondia@innovasolutions.com
(+1) 720-452-1377

PAY RANGE AND BENEFITS:
Pay Range*: $22.00- $24.00- per hour.
*Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits: Innova Solutions offers benefits( based on eligibility) that include the following: Medical & pharmacy coverage, Dental/vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS: Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion. Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions:
Named One of America's Best Employers for New Grads by Forbes 2024
Named One of the Best Companies to Work for by U.S. News & World Report (Private Companies List, 2024-2025)
One of the Largest IT Staffing Firms in the US - Ranked #3 by Staffing Industry Analysts (SIA, 2024)
One of the Largest Staffing Firms in the US - Ranked #13 by Staffing Industry Analysts (SIA, 2024; includes Innova Solutions, Volt, & Hire Genics)
Named One of the Top Ten Private Companies in Atlanta by the Atlanta Business Chronicle (2023)
One of the Largest Certified Minority Business Enterprises (MBEs) in the United States (NMSDC, 2024)
AWS Advanced Tier Services Partner with 100+ certifications


Website: https://www.innovasolutions.com/

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need reasonable accommodation to assist with your job search or application for employment, please contact us at or (770) 493-5588. Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities. Innova Solutions (Hire Genics/Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. - 1324b.
The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

Keywords: Volt, Rio Rancho , Provider Network Representative, Other , Albuquerque, New Mexico