Provider Network Consultant

W3R Consulting; Austin (TX); À distance; USD 39 000 - 44 000; Plein temps

Résumé du poste

W3R Consulting is seeking a Health Insurance Provider Services Coordinator to support Medicare and Medicaid provider operations remotely. You will research and resolve provider inquiries arising from contract operations, system issues, data entry, claims payment, and directory accuracy.

You will collaborate with Provider Network, Provider Relations, and Government Programs teams to resolve issues and educate Medicaid and Medicare providers about policy updates, system changes, and contract

Qualifications

• Bachelor degree OR 2 years in health insurance/managed care handling independent decisions.
• Strong written and verbal communication to educate providers and resolve issues across departments.
• Proficiency in Word and Excel.
• HS Diploma/GED
• Strong Texas Medicare claims and provider relations knowledge.

Responsabilités

• Research and resolve provider inquiries arising from contract operations, system, data entry claims payment, and directory issues.
• Coordinate with Provider Network, Provider Relations, and Government Programs staff on issue resolution.
• Educate and update Medicaid and Medicare provider network regarding policy updates, system changes, and contract changes.
• Assist in the composition and coordination of revised policies and procedures.

Connaissances

Health insurance knowledge

Provider relations

Communication skills

Excel

Formation

Bachelor degree OR 2 year experience

Outils

Word

Excel

Description du poste

Description: This position is responsible for supporting Medicare and Medicaid provider services, provider operations of individual Medicare and Medicaid providers. This position is accountable for researching and resolving provider inquiries arising from contract operations, system, data entry claims payment, and directory issues. This position is responsible for internal communications including working with Provider Network, Provider Relations, and Government Programs staff on issue resolution, This position is responsible for external communications including educating and updating the l Medicaid and Medicare provider network community regarding client's policy updates, system and contractual changes. Assist in the composition and coordination of revised policies and procedures

Job Requirements

• Bachelor degree OR 2 year of experience in health insurance/managed care industry handling independent decision making.
• Written and verbal communication skills to compose responses to external and internal entities, to educate providers, to compose training materials and procedures, to work across departments to resolve provider issues including claim research.
• PC proficiency including Microsoft Word and Excel.
• HS Diploma/GED
• Strong Texas Medicare claims and provider relations knowledge

Preferred Job Requirements

• Bachelor Degree with one year business experience.
• Knowledge of health care industry, contracts, products, claims processing.
• Knowledge of government health care products.

Candidate will be a w3r Consulting employee, contracted to our clientBlue Cross Blue Shield, also known as Health Care Services Corp, or HCSC. This is a W2 contract for 12 months, with the possibility of being hired. Hourly rate is $30.30. This position is 100% remote in Austin, Texas.