Provider Network Administrator

The Provider Network Administrator is responsible for managing and providing service and administrative support to the GLOC Preferred Provider Network.

JOB RESPONSIBILITIES

1. Determine and correct the root cause of Provider queries and ensures speedy resolution and timely 
    feedback to member/ AE/ Agent/ Plan Administrator/ Broker.
2. Provide training and support to providers on GLOC’s systems, policies, procedures and changes.
3. Supply equipment for easiClaim process (eCard reader, claim books and claim forms) to GLOC 
    Network Providers, update policy procedure, schedule of fees and ensure adjudicating rules are 
    clear and adhered to by the 800- line staff.
4. Conduct ongoing site visits to assign GLOC Network Providers to ensure adherence to standards 
     and contractual agreement with GLOC.
5. Maintain Systems, Database, Plexis (PCM) and the GLOC Network Providers directory and website.
6. Enroll, maintain and terminate Preferred Providers on the network and ensure all the relevant 
     parties are notified.
7. Visit and conduct site/ virtual assessment for potential Preferred Providers.
8. Identify aged queries by GLOC Network Providers and conduct research to bring about a resolution.
9. To perform other related duties as assigned by Vice President – Services and the Manager.

EDUCATION & EXPERIENCE

• First Degree in Business Administration, Health Services, Health Care/Hospital Administration or a related field from a recognized tertiary level educational institution OR         Certified Financial Planner certification.
• 5 CXC/ CSEC passes including Mathematics and English Language.
• 2 A’ Level/ CAPE subjects.
• At least 4 years’ experience in a Life, Health and Insurance environment with detailed exposure to group underwriting and marketing.
• Product Knowledge (Group and Individual lines) 
• At least one (1) work experience providing 
   equivalent background required.

ADDITIONAL REQUIREMENT:
As a regulated entity with obligations under the Know Your Employee guidelines, a Certificate of Character is required.

PERSON SPECIFICATION: 
The Provider Network Administrator must be flexible, highly adaptive to changes in the organisation and possess excellent interpersonal skills, with a strong customer service focus. He/ She must be a very meticulous, organised and detail-oriented individual. The individual must possess strong problem-solving skills and be able to make sound decisions.