Senior Network Engineer
Vero Networks
FirewallsiOSSwitchingTCP/IP
Provider Engagement Network Specialist
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Kentucky • 🇺🇸 United States
Visit company websiteSalary
💰 $23 - $39 per hour
Job Level
Mid-LevelSenior
About the role
- Perform day to day duties of assuring that providers are set up accurately in the provider information system for state reporting, claims payment, and directories.
- Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up.
- Provide support to the external provider representative to resolve provider data issues
- Research and effectively respond to provider related issues
- Submit provider data entries to resolve provider-related demographic information changes
- Initiate and process provider add, change and termination forms
- Create and maintain spreadsheets used to produce provider directories for multiple products.
- Track, update and audit provider data
- Identify adds, deletes and updates to key provider groups and model contract
- Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment
- Provide assistance to providers with website registration
- Facilitate provider education via webinar
- Work with other departments on cross functional tasks and projects
- Facilitate new provider orientations
- Facilitate provider trainings
- Performs other duties as assigned
- Complies with all policies and standards
Requirements
- Associate's degree and claims processing, billing and/or coding experience preferred
- Three years of experience in managed care environment, medical provider office, customer service within a healthcare organization, and medical claims.
- Knowledge of health care, managed care, Medicare or Medicaid
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims processingbillingcodingprovider data managementdata entryspreadsheet maintenanceprovider directory creationclaims payment resolutiondemographic information managementprovider education facilitation
Soft skills
problem solvingcommunicationcustomer serviceresearchcross-functional collaborationtraining facilitationorganizational skillsattention to detailsupportadaptability
Certifications
Associate's degree
