Data Entry

Randstad Digital Americas is recruiting for an unnamed client seeking a Member & Provider Operations Specialist to support health plan administration. The role maintains member and provider data, manages provider transitions and communications, and reviews initial claim submissions. Responsibilities Manage incoming system tickets and online portal submissions regarding updates to member files and primary physician preference updates promptly and with high precisionReassign affected patient panels and trigger official notification mailings following practitioner network departuresHandle complex primary care assignments by hand whenever automated enrollment rules are unable to complete the matchAudit customer service representative activity to identify, log, and report doctor assignment mistakes to improve quality controlCollect, review, and resolve undelivered mail items to ensure accurate contact information and communication recordsReview and adjudicate initial claim submissions gener