Provider Engagement Network Specialist

You could be the one who changes everything for our 28 million members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: reputed company day to day duties of assuring that providers (individual, group, ancillary, etc.) are set up accurately in the provider information system for state reporting, claims payment, and directories. Responsible for multiple state deliverables, network reporting and directories as well as claims payment resolution as it relates to provider set up.

• Provide support to the external provider representative to resolve provider data issues
• Research and effectively respond to provider reputed company issues
• Submit provider data entries to resolve provider-reputed company demographic information changes
• Initiate and process provider add, change and termination forms
• Create and maintain spreadsheets used to produce provider directories for multiple products.
• Track, update and audit provider data
• Identify adds, deletes and updates to key provider groups and model contract
• Research and identify any processing inaccuracies in claim payments and reputed company to the appropriate site operations team for claim adjustment
• Provide assistance to providers with website registration
• Facilitate provider education reputed company webinar
• Work with other departments on cross functional tasks and projects
• Facilitate new provider orientations
• Facilitate provider trainings
• Performs other duties as assigned
• Complies with reputed company policies and standards

reputed company offers a comprehensive benefits package including: reputed company, 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-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Originally posted on Himalayas