Network Operations Specialist

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Karna, LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

🤝 Non-profit

🏛️ Government

Healthcare Insurance • Non-profit • Government

Karna, LLC is a public health consulting company that provides high-impact solutions to government, non-profit, and commercial organizations in the areas of science, research, technology, communications, and evaluation. As a member of the Celerian Group, a Blue Cross Blue Shield of South Carolina company, Karna leverages the capabilities of its sister companies to deliver tailored public health and clinical healthcare solutions. The company specializes in population health applications, health analytics, health communication, and public health research and support. Karna's expertise addresses complex issues in public health, such as mental health disparities, diversity, equity, and inclusion programs, and health outcomes evaluation. Their services include technical assistance, third-party administration, and training to improve strategic health goals across various sectors.

📋 Description

• Play an essential behind-the-scenes role in supporting the Provider Relations team and the NIOSH World Trade Center Health Program. • Focus on maintaining accurate provider network data, completing timely data entry and updates, analyzing information for trends or inconsistencies, and helping ensure provider records and documentation are complete, organized, and reliable. • Maintain provider network data across multiple tracking reports, systems, and internal data sources, ensuring records are accurate, complete, and current. • Perform high-volume data entry, data validation, and record maintenance related to provider demographics, enrollment documentation, contract status, and other network information. • Review provider data for accuracy, consistency, duplicates, missing information, and potential discrepancies; research issues and coordinate corrections through established processes. • Prepare, update, and analyze reports to support provider network operations, identify trends, monitor pending items, and assist the team with prioritizing follow-up work. • Support the secure exchange, tracking, and organized management of provider enrollment and network documentation in accordance with program requirements and internal procedures. • Assist with incoming internal requests, shared mailbox items, ServiceNow tickets, and escalated operational questions by researching information, updating records, and routing items appropriately. • Partner with internal stakeholders to support timely resolution of provider data issues, claims-related research, grievances, compliance reviews, and other operational needs. • Follow standard operating procedures, maintain accurate documentation of work completed, and recommend process improvements that strengthen data integrity and team efficiency.

🎯 Requirements

• Bachelor’s degree preferred; equivalent combination of education and relevant experience accepted. • 2–5 years of experience in healthcare operations, provider network operations, provider data management, claims support, enrollment, credentialing support, or a related back-office healthcare environment. • Strong data entry, data validation, and record maintenance skills, with a demonstrated commitment to accuracy, completeness, and confidentiality. • Proficiency with Microsoft Excel, including sorting/filtering, basic formulas, formatting, data cleanup, and comparison of information across multiple data sources; intermediate Excel skills preferred. • Experience working in multiple systems or databases and comfort learning new applications, workflows, and reporting tools. • Ability to analyze information, identify patterns or discrepancies, research root causes, and support practical solutions. • Excellent attention to detail, organization, follow-through, and ability to manage recurring tasks, competing priorities, and deadlines. • Professional written communication skills and ability to collaborate effectively with internal and cross-functional partners. • Familiarity with HIPAA, protected health information, provider enrollment, claims, credentialing, ServiceNow, or provider data systems is helpful but not required.