Senior Provider Engagement Specialist

Job Summary

A company is looking for a Senior Provider Engagement Network Specialist.

Key Responsibilities

• Ensure accurate provider setup in the information system for state reporting, claims payment, and directories
• Act as the internal and external liaison for provider networking and manage relationships with participating providers
• Research and resolve complex provider-related issues, including contract loading and claims disputes

Required Qualifications

• Bachelor's degree in a healthcare-related field or equivalent experience required
• 5+ years of provider services experience, preferably in a managed healthcare environment
• Experience with provider contracting and servicing benefits interpretation
• Strongly preferred experience in hospital or physician office claims billing
• Experience managing projects independently and public speaking