Provider Network Director directs and develops a healthcare provider network. Designs and administers policies and services that comply with all contractual and regulatory requirements. Being a Provider Network Director requires a bachelor's degree. Typically reports to top management. The Provider Network Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Provider Network Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Job Summary
The Service Advocate IV - Network Management is part of a specialized call center who provides education and assistance for contracting, credentialing and Availity issues. This Service Advocate IV role assists the provider in maintenance and directs them on how to request changes to their contract. The position is responsible for providing the group or individual with the tools needed to make the updates via Availity and to give Credentialing data to the groups. The team researches issues and documents the findings, using six or more systems on a daily basis. The position coordinates with multiple departments to correct data discrepancies and provide the group or individual the data needed, if the area cannot assist with the update, i.e. update license in Availity when claims are impacted.
Important to Know: This is a remote position, and this role requires virtual one-on-one training for 3 months. This position is a fast-paced inbound call center supporting our providers with contracting and credentialing issues.
What You Will Be Doing:
What You Must Have:
2 years related work experience. Experience Details: in a healthcare or customer service environment
High school diploma or GED
Basic knowledge of HCFA and 1500 claim forms, medical terminology, HCPCS and CPT codes
Excellent verbal and written communication skills; ability to speak in a clear and articulate manner
Basic knowledge of Microsoft applications such as Outlook, Word, and Excel.
Demonstrated ability to develop and strengthen relationships with internal and external business partners
Able to successfully handle multiple tasks and changing priorities
Effectively display a positive attitude and work efficiently in a team environment
What We Would Prefer:
Inbound call center experience
Experience in a health care environment Bilingual in Spanish and English 1 years’ experience with Diamond, Siebel and PIP (Provider Information Platform)
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.
To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:
Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.
To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.
Typical Hourly Pay Range: $18 - $22
Hourly Pay Range: $18 - $29
Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.
We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.
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0 Provider Network Director jobs found in Pensacola, FL area