Provider Data & Network Engagement Specialist (Remote)

Peach State Health Plan, Inc.; Missouri; Remoto; USD 32.000 - 55.000; Tempo pieno

Descrizione del lavoro

Centene is seeking a Provider Data Specialist to ensure accurate setup of providers in the provider information system for state reporting, claims payment, and directories.

You will support external provider representatives, research provider data issues, process add/change/termination forms, and help maintain directories across multiple products. Remote position with EST business hours.

Competenze

• Associate's degree required.
• Three years of experience in managed care, medical provider office, or healthcare customer service.
• Knowledge of health care, managed care, Medicare or Medicaid.

Mansioni

• Provide support to external provider representatives to resolve provider data issues.
• Research and respond to provider-related issues.
• Submit provider data entries to resolve demographic information changes.
• Initiate and process provider add/change/termination forms.
• Create and maintain spreadsheets to produce provider directories.
• Track, update and audit provider data.
• Research processing inaccuracies in claim payments and route for adjustment.
• Provide assistance to providers with website registration.
• Facilitate provider education via webinar.
• Assist other departments on cross-functional tasks and projects.
• Facilitate new provider orientations and trainings.

Conoscenze

Provider data management

Claims processing

Customer service

Formazione

Associate's degree

Descrizione del lavoro

Centene is seeking a Provider Data Specialist to ensure accurate setup of providers in the provider information system for state reporting, claims payment, and directories.

You will support external provider representatives, research provider data issues, process add/change/termination forms, and help maintain directories across multiple products. Remote position with EST business hours.