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Provider Network Specialist I
3 months ago
Applicants must be eligible to begin work on the date of hire. Applicants must be currently authorized to work in the United States on a full-time basis. ARKANSAS BLUE CROSS BLUE SHIELD will NOT sponsor applicants for work visas in this position.
Arkansas Blue Cross is only seeking applicants for remote positions from the following states:
Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wisconsin.
Workforce Scheduling
Job Summary
The Provider Network Specialist performs a variety of operational support activities, relate to enrollment, credentialing and contracting, ensuring that all casework is completed accurately, on time and in compliance with established policies and guidelines
Requirements
EDUCATION
High School diploma or equivalent.
EXPERIENCE
Minimum two (2) years' operations support experience related to provider networking, claims processing, customer service, membership enrollment or related experience.
ESSENTIAL SKILLS & ABILITIES
Interpersonal Communication
Oral & Written Communication
Credentialing
Provider Contracts
Problem Solving
Decision Making
Microsoft Office
Detail Orientation
Taking Initiatives
Self-Motivation
Highly Organized
Detail-Oriented
Build Positive Relationship
Skills
Decision Making, Detail-Oriented, Group Problem Solving, Interpersonal Relationships, Microsoft Office, Oral Communications
Responsibilities
Performs all provider related administrative tasks such as provider enrollment, data maintenance, provider number assignment, credentialing, correspondence, document preparation, etc. Thorough documentation of actions, records and/or correspondence is required., Performs other duties as assigned, Resolves issues and communicate more difficult problems to the next level support or leadership., Works collaboratively with various internal departments, external resources, and/or providers to resolve issues, while keeping leadership inform of progress and resolutions.
Certifications
Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
Employment Type
Regular
ADA Requirements
1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.
