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Provider Network Specialist I
AUBURN WA 98001
Category: Health Care Industry
  • Your pay will be discussed at your interview

Job code: lhw-e0-85755480

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Centene Corporation

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Summary

  Job posted:   Tue Mar 13, 2018
  Distance to work:   ? miles
       
  1 Views, 0 Applications  
 
Provider Network Specialist I
ProfessionalPosition Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.Serve as primary contact for providers and act as a liaison between the providers and the health planConduct monthly face-to-face meetings with the provider account representatives documenting discussions, issues, attendees, action items, and research claims issues on-site, where possible, and route to the appropriate party for resolutionReceive and effectively respond to external provider related issuesProvide education on health plan's innovative contracting strategiesInitiate data entry of provider-related demographic information changes and oversee testing and completion of change requests for the networkInvestigate, resolve and communicate provider claim issues and changesEducate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topicsPerform provider orientations and ongoing provider education, including writing and updating orientation materialsAbility to travel


TITLE: Provider Network Specialist I


LOCATION: , Washington


REQNUMBER: 1090614


COMPANY: Network Development & Contracting


POSITION TYPE: Professional


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