Vacancy expired!
Job Description
Position can be anywhere in the state of VermontPosition Purpose:Serve as primary contact for providers serving as a liaison between the provider and the health planPerform 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
Qualifications
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.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Vacancy expired!