The Opportunity

Be a valued contributor to The Alliance’s mission to Move Healthcare Forward

The Alliance moves health care forward by controlling costs, improving quality, and engaging individuals in their health. As a not-for-profit, employer-owned cooperative, we exist to help our members manage their health care dollars while positively impacting their employees’ health.

As Provider Operations Assistant, you are responsible for supporting The Alliance’s vast provider network by facilitating a seamless enrollment and credentialing process, maintaining an accurate and up-to-date provider network and claims portal, and ensuring an overall high-quality experience with a prompt resolution of issues and exceptional communication. 

The Responsibilities

Provider Network Enrollment, Maintenance, and Monitoring:  

  • Collect, interpret, enter, and maintain participating provider records into the processing system promptly and accurately.  
  • Ensure internal and external stakeholders receive timely communication of any changes as necessary. 
  • Serve as a resource for network providers, including responding to questions, collecting information, identifying impactful changes, and preparing provider communications.  

Credentialing Maintenance:  

  • Collect and maintain data elements crucial to the provider credentialing process. 
  • Communicate credentialing application approvals to providers.

Claims Portal:  

  • Maintain network provider access to the online claims portal. 
  • Respond to questions and concerns from network providers or internal staff.
  • Train network providers on the use of the claims portal.

Other Projects and Duties:

  • Support contractors’ efforts to achieve high-value contracts with providers.  
  • Recommend enhancements to processing systems toward work efficiencies and accuracy.
  • Assist with external inquiries as guided by contractors or provider operations staff.  
  • Work with other departments as needed to resolve issues related to the provider directory or claims. 
  • Collect miscellaneous customer feedback received by Alliance staff.

The Requirements

The ideal candidate has a high school diploma, or equivalent, training or coursework in word processing and/or business, and a minimum of two years’ experience, preferably in the healthcare or insurance industry.  Experience working with physician demographic data, managed care contracts and/or claims data preferred. Intermediate math skills a plus. Strong communication skills are a must – both written and verbal – as well as responsiveness and the ability to solve problems and effectively convey solutions to internal and external customers. Proficiency with Microsoft Office software, including Word, Excel, and PowerPoint, along with experience using Adobe Acrobat products, is essential.  Successful candidates must have the ability to work in the U.S. without sponsorship.  

The Organization

As a not-for-profit cooperative, The Alliance is employer-owned and remains a trusted, objective partner for employers and their brokers who seek improved access to high-quality healthcare.

We’re Madison-based, but we work with 300+ employers across the Midwest and contract with over 34,000 doctors and other health care providers in the region. Our goal is to help employers better manage their healthcare costs while remaining transparent and emphasizing value – creating healthier, more engaged workforces.

The Alliance is celebrating over 30 years as a mission-driven and member-focused collective with experienced leadership and strong organizational departments backed by top talent.  By joining The Alliance, you’ll become part of a passionate, collaborative, and supportive organization: one that fosters meaningful connections and relationships with high levels of employee engagement and satisfaction.

Our health plan is self-funded, which means we share the same interests and use the same tools that we offer our clients. We lead by example because when we take care of our employees, they take care of our clients (and their employees.)

We set our employees up for success, encouraging not only their professional advancement but also their personal growth. We offer a competitive compensation and benefits package, including health/dental/vision/life insurances, a generous Staff Incentive Bonus program, 401(k), and annual Continuing Education and Wellness benefits. 

We offer flexible scheduling, including working 4 ½ days/week during the summer. Additionally, post-training, this position can mostly work remote – if desired – with the periodic need to attend in-person meetings with teammates or other key stakeholders.

The Alliance is committed to Diversity, Equity, and Inclusion and is an Equal Opportunity Employer.

To learn more about The Alliance click here.

The Alliance is unable to provide sponsorship for a H1-B work visa at this time.

Equal Opportunity Employer.