Medical Provider Network Relations Specialist

3 hours ago


Greenwood Village, Colorado, United States CorVel Corporation Full time
Job Summary

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
Requirements
  • 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
What We Offer

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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