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Provider Network Support Specialist I

Company: Centene
Location: Springfield
Posted on: January 16, 2022

Job Description:

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Perform 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 issuesResearch and effectively respond to provider related issuesSubmit provider data entries to resolve provider-related demographic information changesInitiate and process provider add, change and termination formsCreate and maintain spreadsheets used to produce provider directories for multiple products.Track, update and audit provider dataIdentify adds, deletes and updates to key provider groups and model contractsResearch and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustmentProvide assistance to providers with website registrationFacilitate provider education via webinarWork with other departments on cross functional tasks and projectsFacilitate new provider orientationsFacilitate provider trainingsCompletes special projects as assigned*Minimal travel is required each quarter to attend staff meetings in Chicago*Our Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibilityCompetitive payPaid Time Off including paid holidaysHealth insurance coverage for you and dependents401(k) and stock purchase plansTuition reimbursement and best-in-class training and developmentEducation/Experience:Associates degree and claims processing, billing and/or coding experience preferred.Three years of experience in managed care environment, medical provider office, customer service within a healthcare organization, and medical claims.Knowledge of health care, managed care, Medicare or Medicaid.Additional skills: interpersonal/verbal & written communication skills, -organizational skills, -time management and priority setting, -customer service, ability to work independently and multi-task, problem solving & analytical skillsCentene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Job SummaryJob number: 1265120Date posted : 2021-12-22Profession: Business Dev & SalesEmployment type: Both

Keywords: Centene, Springfield , Provider Network Support Specialist I, Other , Springfield, Illinois

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