Job Description
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. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.
+ Serve as primary contact for providers and act as a liaison between the providers and the health plan
+ Conduct monthly face-to-face meetings with the provider account representatives documenting discussions, issues, attendees, action items, and research claims issues on-site, where possible, and route to the appropriate party for resolution
+ Receive and effectively respond to external provider related issues
+ Provide education on health plan's innovative contracting strategies
+ Initiate data entry of provider-related 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 regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
+ Perform provider orientations and ongoing provider education, including writing and updating orientation materials
+ Ability to travel as needed
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Bachelor's degree in related field or equivalent experience. 0-2 years of provider relations or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Bachelor's degree in healthcare or a related field preferred. Claims billing/coding knowledge preferred.
**Licenses/Certifications:** Current state driver's license.
This position location is required to come into the office in Tempe, Arizona at minimum twice a month. Candidates must reside within Arizona to be considered for this opportunity.
Pay Range: $22.79 - $38.84 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.
Centene 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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Job Tags
Hourly pay, Holiday work, Remote job, Flexible hours,
Similar Jobs
TEI Construction Services, Inc.
...Position Summary Assemble, install, maintain, and repair boilers, closed vats, and other large vessels or containers that hold liquids and gases. Essential Functions Read blueprints to determine locations, positions, and dimensions of boiler parts Install...
PrimeVigilance
...size pharmacovigilance service provider initially... ...excellent training and development platform. We value employee... ...The role of business development within the... ...potential in the business the Director, Business Development... ...Development team and Functional Managers, to cultivate strong,...
Rubirosa International Realty
Join Our Team! Seeking Dynamic Real Estate Agents in the Miami Area Are you a passionate and driven real estate professional looking... ...a diverse clientele, representing exclusive residential and commercial properties in the Miami area. Your responsibilities will include...
RentVision
...Are you a photo and video enthusiast who thrives on turning raw content into polished, professional visuals? Do you get excited about... ...lighting, color, and clarity? Join our Media Team as a Photo and Video Editor, where you will play a key role in producing impactful content...
AUDI JLR LOTUS BMW MOTO
Job SummaryAudi Cape Fear is seeking an experienced Automotive Service Advisor to join the team. This position requires exceptional customer service skills with a passion for the Automotive industry. The primary role of this position is to act as the liaison between the...