Remote Senior Provider Relations & Data Integrity Specialist

Centene Corp.; New York (NY); Remote; USD 56,000 - 101,000; Full time

Benefits offered by this job

Comprehensive benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Job summary

Centene Corporation is seeking a Provider Relations Specialist to ensure accurate provider setup in our information systems for state reporting and directories. You will act as a main liaison between providers and Centene, resolving complex data issues and contract interpretations while supporting external provider representatives.

The role requires a Bachelor's degree in a healthcare field (or equivalent) and 5+ years in provider services within managed care.

Qualifications

• Bachelor’s degree in healthcare related field or equivalent experience required.
• 5+ years of provider services experience in a managed health care environment with exposure to provider contracting, servicing benefits interpretation, and internal operations of provider relations.

Responsibilities

• Ensure providers are set up accurately in the provider information system for state reporting and directories.
• Serve as primary liaison between providers and Centene health plan, resolving data issues and complex provider contracts.
• Provide training and education to providers, oversee provider databases, and act as department SME.
• Research and resolve complex problems related to contracts, rate language, appeals and eligibility.

Skills

Provider relations

Data analysis

Customer service

Communication

Education

Bachelor's degree in healthcare

Tools

CRM software

Job description

Centene Corporation is seeking a Provider Relations Specialist to ensure accurate provider setup in our information systems for state reporting and directories. You will act as a main liaison between providers and Centene, resolving complex data issues and contract interpretations while supporting external provider representatives.

The role requires a Bachelor's degree in a healthcare field (or equivalent) and 5+ years in provider services within managed care.