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Provider Relations Coordinator

2 months ago

Trenton, New Jersey, United States Centene Corporation Full time
Job Summary

We are seeking a skilled Healthcare Network Liaison Specialist to join our team at Centene Corporation. As a key member of our organization, you will play a vital role in building and maintaining strong relationships with healthcare providers, ensuring seamless communication and collaboration to drive business growth and excellence.

Key Responsibilities
  • Act as a liaison between healthcare providers, the health plan, and corporate entities to facilitate effective communication and issue resolution.
  • Develop and implement training programs to enhance provider performance and knowledge of health plan policies and procedures.
  • Conduct regular face-to-face meetings with provider account representatives to discuss key issues, action items, and research claims-related matters.
  • Provide education on health plan contracting strategies and policies to healthcare providers.
  • Initiate data entry of provider demographic information changes and oversee testing and completion of change requests for the network.
  • Investigate, resolve, and communicate provider claim issues and changes.
  • Educate providers on policies and procedures related to referrals, claims submission, website usage, and EDI solicitation.
  • Perform provider orientations and ongoing education, including writing and updating orientation materials.
Requirements
  • Bachelor's degree in a related field or equivalent experience.
  • 0-2 years of provider relations or contracting experience.
  • Knowledge of healthcare, managed care, Medicare, or Medicaid.
  • Claims billing/coding knowledge preferred.
  • Current state driver's license.
What We Offer

Centene Corporation offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off, and a flexible approach to work with remote, hybrid, field, or office work schedules.