Provider Relation Specialist I
4 weeks ago
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices.
Serve as primary contact for providers serving as a liaison between the provider and the health plan Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on site and routing to the appropriate party for resolution Receive and respond to external provider related issues Initiate entry or change of provider related database information and oversee testing and completion of change request Investigate, resolve and communicate provider claim issues and changes Educate providers regarding policies and procedures related to referrals and claims submission, web site education, EDI solicitation and problem solving Perform provider orientations, including writing and updating orientation materials Ability to travel Performs other duties as assigned Complies with all policies and standards Education/Experience: High school diploma or equivalent. Bachelor’s degree in healthcare related field preferred. 3+ years of sales, provider relations, or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Claims billing/coding knowledge preferred. Driver’s License may be required by some plans. Specific language skills may be required by some plans.License/Certification: Valid driver's license.Pay Range: $22.36 - $38.07 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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