REMOTE - Senior Managed Care Network Operations Specialist
: Job Details :

Senior Managed Care Network Operations Specialist assists, through site visits, large group presentation and one-on-one interactions with physicians, hospitals and ancillary providers, PHO and network individuals billing offices and patients in realizing our goal to provide high-quality, cost-efficient medical benefits for all our product lines. Senior Managed Care Network Operations Specialist responds to credentialing application requests from payors, as well as overseeing claim, fee schedule and contract language disputes, assisting members with finding network providers and resolving other payor/provider/member related issues as pertaining to contracts. By educating, updating and resolving these problems, the Senior Managed Care Network Operations Specialist helps our providers to develop a positive working attitude toward our products and policies, to maintain strong working relationship with our payor population, as well as serving our members to the best of their abilities. Seni...Network Operations, Operations Specialist, Operations, Senior, Network, Specialist, Technology, Healthcare