Medical Provider Network Relations Specialist
3 hours ago
We are seeking a highly skilled Medical Provider Network Relations II to join our team at CorVel Corporation. As a key member of our network development team, you will be responsible for providing exceptional customer service while ensuring the integrity of our provider data.
Key Responsibilities- Assist in implementing medical providers through correspondence and telephonic contact
- Verify provider signatures, contracts, and documentation before submitting for internal processing
- Review credentials of prospective providers to ensure compliance with national credentialing requirements and protocols
- Provide orientation on managed care procedures and establish liaisons with participating providers
- Assist in developing and maintaining provider manuals and orientation materials
- Resolve disputes involving provider contracts and payment issues
- Provide assistance and support to staff requests for information regarding the network
- Oversee the distribution of executed contracts and maintenance of database
- Assist with network marketing, employer, and payor relations, and product development
- Conduct and manage provider data audits to ensure data integrity
- Coordinate and process provider roster updates
- Perform facility site surveys as needed
- Identify anemic specialties within the network and generate a recruitment list
- Associate's degree or two or more years of equivalent work experience
- Proficient in Microsoft applications
- Customer service education/training within the insurance industry, managed care, or related field
CorVel Corporation offers a comprehensive benefits package, including medical, 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, 401(k), ROTH 401(k), and paid time off.
We are an equal opportunity employer and comply with ADA regulations as applicable.
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