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Network Relations Specialist I
3 months ago
The Network Relations Specialist is responsible for overseeing provider data integrity while providing excellent customer service. This individual must combine strong interpersonal skills with an aptitude in the medical provider market.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
Assist Developer with implementing medical providers through use of correspondence and telephonic contact. Verify all provider signatures, contracts and documentation before submitting for internal processing. Review credentials of prospective providers to be considered for acceptance into network per national credentialing requirements and protocols. Provide orientation on managed care procedures and establish liaison(s) with all participating providers. Assist and communicate a provider orientation program in cooperation with Developer. Distribute and maintain provider manual and orientation materials per state guidelines. Receive and resolve all disputes involving provider contract and payment issues in accordance with contract Dispute Resolution Procedures. Oversee distribution of executed contracts and maintenance of database. Conduct and manage provider data audits that ensure data integrity for network and oversee all provider updates and changes with NDB. Coordinate and process provider roster updates regularly and as appropriate. Maintain a professional appearance. Requires regular and consistent attendance. Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”). Additional projects and duties as assigned.KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills. Continually adapt daily routines that allow each function to be manageable. Ability to identify, analyze and solve problems. Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management and organizational skills. Ability to work both independently and within a team environment.EDUCATION/EXPERIENCE:
High school diploma or equivalent. Customer service education/training within the insurance industry, managed care, or related field.PAY RANGE:
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $15.98 - $25.69 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
About CorVel
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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