Provider Network Specialist

Job Summary

A company is looking for a Provider Network Specialist to ensure clients and Managed Care Organization's covered employees receive accurate information regarding eligibility and services.

Key Responsibilities

• Provide information to clients and covered injured workers on eligibility, coverage, and procedures related to MCO services
• Collaborate with the Medical Director and vendors on provider credentialing and network issues
• Track and verify the acceptance of new workers' compensation patients and maintain MCO status updates

Required Qualifications

• Bachelor's degree from an accredited college or university preferred
• Four years of related experience or equivalent education and experience, including three years in customer service and one year in analytics
• Managed Care experience preferred
• Thorough knowledge of MCO regulations and practices
• Proficiency in Microsoft Office products