Provider Data Senior Associate

Company Name:
Develops and maintains positive relationships with physicians, providers, practice managers, hospitals, LTSS and/or ancillaries within the provider network.
Provides internal support to Physician/Provider Network team. Researches and resolves provider issues. Prepares documentation for meetings, schedules meetings, visits PCP/specialist offices for relationship building, and educates providers regarding member benefits and referral process. Develops, maintains, and distributes reports. Performs quality checks on provider communication material. Assist in maintaining provider contract files and system information accurate and correct. May be responsible for support of the physician, LTSS and ancillary network team through problem resolution and researching appeals for providers through claims review, pricing, and authorization requirements. May research MSM inquiries through the claims systems to resolve discrepancies and draft letters to send to providers for resolution to issues.
Minimum: High School Diploma or GED. At least one year customer service, claims, and/or payer related experience.
Preferred: Bachelor's degree. Experience in physician relations or managed care and Texas Medicaid.
Job: Provider--Network/Data Mgmt
Title: Provider Data Senior Associate
Location: Texas-Bedford
Requisition ID: 14003078

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