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Provider Network Support Representative Jobs

Provider Support Assistant Jobs
By Duke Health At , Durham, 27710
Make template/schedule changes pending managerial approval.
Manage urgent clinic and appointment scheduling
Manage patient rescheduling in cases of provider emergency and/or absences
Receive medical records from home physicians and deliver to HIM or scan to HIM and S drive
Correspondence, credentialing, licensing and certification, reference materials, publications, professional memberships, and renewal of licenses/DEA/privileges
High school diploma or equivalent education required.
Analyst, Network & Provider Analytics
By Point32Health At , Remote
Under direct supervision, conduct detailed analyses that offer the Provider Performance Management team insights into cost drivers and best practices
Bachelors in Business Administration, Finance, Health Services required; Masters preferred
Strong oral, written and presentation skills
Key Responsibilities/Duties – what you will be doing
Qualifications – what you need to perform the job
Work under direct supervision to generate and enhance standard cost and utilization reports
Provider Data Specialist_ Provider Network
By Versant Health At , Remote $18.50 - $20.00 an hour
One to three (3) years of data entry experience
Peer review of database revisions to meet Quality Check requirements
One to three (3) years of experience working with claims and/or provider demographic information
Experience working with provider networks and healthcare providers
Ability to use MS Excel and Access to manage work items and manipulate data, preferred
Previous experience in running a wide variety of Geo Access and/or Quest Analytics reports is preferred
Provider Network Specialist Jobs
By Premera Blue Cross At United States
Provide input on improvements regarding workflow, procedures, or policies and make recommendations to management.
Assure compliance with the National Committee for Quality Assurance (NCQA), Office of the Insurance Commissioner (OIC) and other regulatory agencies/requirements.
Three (3) years' experience in a production or customer service environment requiring attention to detailed procedures (Required).
One year of prior health care and provider information experience; medical office or billing experience.
Knowledge of other internal department operations or functions that assist in resolution of provider inquiries.
Experience in working with Microsoft Word and Excel.
Director Of Provider Network Development
By JLC Recruiting New York At United States
Thorough knowledge of laws and regulations relating to managed care and other payer functions.
This role is remote based (work from home) and will require approximately 35% travel throughout NY State
Administration (MHA); or equivalent education/experience such as bachelor’s degree in
a minimum of 10 years in leadership position-management of field-based teams
In partnership with National and local leadership, develop contracting growth strategies across all lines of the managed care portfolio.
Develop market level contracting strategies and alignment with finance and other operational areas of the organization.
Provider Network Manager Jobs
By Elevance Health At United States
Contracts frequently involve non-standard arrangements that require a moderate level of negotiation skills.
Job Family: Digital and Technology
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Primary focus of this role is contracting and negotiating contract terms for value-based agreements.
Typically works with providers engaged in value-based arrangements and non-traditional provider types supporting SDOH initiatives and whole-health care delivery.
Deep understanding of Value based concepts understanding and innovative thoughts on health equity and whole-health.
Provider Network Executive Iii
By Premera Blue Cross At United States
Develop and execute ongoing account management and service strategy to meet corporate strategic/financial objectives.
Bachelor’s Degree or (4) years of experience in a provider or payer environment. (Required)
Knowledge of network development and provider/vendor network recruitment.
Knowledge of provider community and market anomalies.
Demonstrated ability to effectively manage complex contract negotiations.
Strong experience and expertise in Provider Relations.
Provider Network Account Specialist
By HonorHealth At Scottsdale, AZ, United States

network development or physician recruiting/sales

This is a Full-time position, but requires you to travel locally to meet with potential clients.

Family Support Provider Jobs
By State of Oklahoma At Moore, OK, United States
Develop, enhance, and coordinate relationships with families.
Provide advocacy for children and families.
Act as liaison between children and families and the local Community Team.
Coordinate community organization at local Systems of Care sites.
Participate in advocacy to various statewide organizations and state government entities.
May participate on State Systems of Care Team
National Provider Network Coordinator
By iCare Health Solutions At United States

Description The National Provider Network Coordinator will work closely with the Provider Recruiting and Contracting team(s) to organize recruitment efforts, providing analytical and administrative ...

Provider Network Reporting Analyst
By Medical Mutual of Ohio At ,
1-year experience in health insurance provider operations/data management which includes exposure to network reporting or similar analytics.
2 years’ experience as a Provider Network Reporting Analyst or equivalent experience in health insurance provider operations/data management.
5 years progressive experience as a Provider Network Reporting Analyst or equivalent experience in health insurance provider operations/data management.
Bachelor’s degree in Business Administration, Statistics or related field or equivalent combination of training/education and experience.
Acts as a resource for colleagues with less experience
Knowledge of provider data structure, including tax ID, demographics, etc.
Network Manager Provider Partnerships
By Blue Cross Blue Shield of Massachusetts At , Hingham, 02043, Ma $90,090 - $110,110 a year

***This position is eligible in the following personas:

Provider Network Data Analyst I
By AmeriHealth Caritas At , Raleigh, Nc
Management requirements are adhered to including language, terms and reimbursement requirements
Demonstrates a functional knowledge of provider data and managed care provider reimbursement methodologies.
Knowledge of Managed Care concepts
Responsible for the accuracy and timely management of the provider contracts
Bachelor’s Degree or equivalent education with work experience required.
Responsible for data intake process including knowledge of relevant systems required to complete job functions.
Provider Network Manager - Elevance Health
By Elevance Health At Albany, NY, United States
Experience in fee schedule development using actuarial models strongly preferred.
Experience with value-based contracting such as full risk models.
Job Family: Digital and Technology
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Works with increased independence and requires increased use of judgment and discretion.
May work on cross-functional projects requiring collaboration with other key areas.
Manager, Provider Support Jobs
By Exact Sciences At United States
Support and comply with the company’s Quality Management System policies and procedures.
Develops the customer service and professional skills of team members to increase their value-add to the team and organization.
Manages and resolves customer complaints, identifies, and escalate priority issues while working collaboratively on the corrective action
Identifies and shares best practices and drives for continuous improvement of the customer experience.
Supervise staff including but not limited to organize and prioritize work, write/conduct performance reviews, train/develop, and manage work performance.
Excellent verbal and written English communication skills.
Provider Network Analyst Iii
By Medica Services Company LLC At , Minnetonka, 55305, Mn
Time management skills and ability to meet deadlines
Bachelor's degree or equivalent experience in related field
5+ years of work experience in data analysis and reporting beyond degree
Advanced skills in Excel and Access required
Must possess strong decision making skills
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

Are you looking for an exciting opportunity to help people while using your technical skills? We are looking for a Provider Network Support Representative to join our team and provide excellent customer service to our providers. You will be responsible for responding to inquiries, resolving issues, and providing technical support. If you have excellent communication skills and a passion for helping others, this could be the perfect job for you!

Overview Provider Network Support Representatives are responsible for providing support to providers and customers in the healthcare industry. They are responsible for ensuring that providers are properly credentialed and that all provider information is up to date. They also provide customer service to providers and customers, and assist with any issues that may arise. Detailed Job Description Provider Network Support Representatives are responsible for providing support to providers and customers in the healthcare industry. They are responsible for ensuring that providers are properly credentialed and that all provider information is up to date. They also provide customer service to providers and customers, and assist with any issues that may arise. They must be knowledgeable about the healthcare industry and be able to effectively communicate with providers and customers. They must also be able to troubleshoot any issues that may arise. Job Skills Required
• Excellent customer service skills
• Knowledge of the healthcare industry
• Ability to troubleshoot and resolve issues
• Excellent communication skills
• Ability to work independently and as part of a team
• Ability to multitask and prioritize tasks
• Proficiency in Microsoft Office Suite
Job Qualifications
• Bachelor’s degree in a related field
• Previous experience in a customer service role
• Knowledge of the healthcare industry
• Knowledge of provider credentialing processes
• Ability to work independently and as part of a team
Job Knowledge
• Knowledge of the healthcare industry
• Knowledge of provider credentialing processes
• Knowledge of customer service principles and practices
• Knowledge of Microsoft Office Suite
Job Experience
• Previous experience in a customer service role
• Previous experience in the healthcare industry
• Previous experience with provider credentialing processes
Job Responsibilities
• Provide customer service to providers and customers
• Ensure that providers are properly credentialed
• Maintain up to date provider information
• Troubleshoot and resolve any issues that may arise
• Assist with any other tasks as needed