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Provider Network Management Specialist
4 months ago
Aloha One of Hawaii's largest Healthcare Insurers is looking for a Provider Network Management Specialist. 1-2 years of experience working in the Healthcare industry and exposure to claims processing and medical billing is highly desired
Description:
The Provider Network Management Specialist Analyst is responsible for managing both individual and group provider relationships with the client including provider recruitment, standard contracting, onboarding, claims training and resolution of providers’ issues including those related to claims payment, quality and performance initiatives, improved access and controlling unnecessary costs. Ensures that contract and regulatory network adequacy requirements are met by continuously developing new provider relationships while strengthening existing relationships. Supports the implementation of business changes to simplify operations and improve all provider business experiences.
Occasional off-site visits to resolve servicing issues, gather provider market intelligence, contract related concerns and provide education to ensure and strengthen relations with providers.
Skills:
Provider Enrollment, Health Insurance, Relationship Management, Provider Billing, Healthcare Claim, Provider Support, and Medical Policy
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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