• Job Type:Contract

Posted 3 days ago

Job Description:

Credentialling Experience is A HUGE PLUS
Work hours: 9-5
Recruit candidates from WITH IN NC ONLY

• Compile appropriate information to make requested contractual and demographic updates and changes related to provider data in the systems of record in an accurate, complete and timely manner.

• Manage and sustain positive provider relationships.

• Configure providers and networks in systems of record, assign provider numbers and communicate with provider community.

• Facilitate accurate financial claims payment and provider directory processes.

• Represent client to external provider communities and internal stakeholder groups.

• Accurately complete provider configuration in provider systems of record to ensure appropriate claims payment in accordance with contractual language.

• Compile, analyze, and verify the required information for provider enrollment, contracts, and maintenance for completeness and accuracy, and enter it into the systems of record.

• Communicate, orally and in writing, directly with providers to resolve questions and issues regarding updates and changes in the systems of record.

• Research, respond to, analyze and resolve complex claims issues related to provider setup and provider eligibility on a daily basis.

• Create resolution documents to address provider issues and increase provider satisfaction. Utilize probing and problem solving methods to resolve all inquiries/requests. Identify, understand and anticipate providers unexpressed needs and concerns.

• Provide cross functional support and serve as Subject Matter Experts (SMEs) or second tier resolution to internal and external provider teams.

• Manage timely responses to external provider inquiries and requests. Evaluate new service requests from providers to determine appropriate actions for recording into the systems of record.

• Perform gap analysis on requests and follows through with communication and/or education to providers on internal process and issues.

• Recommend, and participate in process improvement opportunities for Network Management Operations.

• Identify system problems, gaps or inconsistencies in workflows and/or processes.

• Recommend appropriate updates, alternatives and solutions.

Hiring Requirements:

• High school diploma or GED.

• 3+ years of experience in related field.

• Compile appropriate information to make requested contractual and demographic updates and changes related to provider data in the systems of record in an accurate, complete and timely manner.

• Manage and sustain positive provider relationships.

• Configure providers and networks in systems of record, assign provider numbers and communicate with provider community.

• Facilitate accurate financial claims payment and provider directory processes.

• Represent client to external provider communities and internal stakeholder groups.

• Credentialling Experience is A HUGE PLUS.

• Work hours: 9-5.

• Recruit candidates from WITH IN NC ONLY.

About ASK: ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities.

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.