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Provider Relations/Network Operations Rep
Job ID:00004FJZ
Category:MedicalDental
Location:CA Camarillo
Hours:40 Monday to Friday 800am to 500pm
Pay:$25.00 $25.00
Great opportunity in Camarillo CA
Job Description
This position includes performing all activities related to provider data base management and internal provider relations functions. Ensure accuracy and timeliness of data entry of provider network data into the Provider Relations department software. Assist with the maintenance of all provider data. Assist Management with the network development team activities to produce timely and positive results. Provide timely handling and completion of assigned projects. Provide regular and timely reports for all assigned projects. Improve the efficiency of the Network Operation process and procedures to enhance quality and efficiency. Be able to respond to claims submission questions and have a good understanding of provider claims submissions. Provide timely and accurate submission al of all company requested projects, assignments and reports. Communicate with providers and their staffs to obtain and provide follow up information. Work with providers to adhere to contract and regulatory requirements. Data entry, audit, daily maintenance of the PR department master data. Research, review and make updates to user requests within provider data management system. Review provider setup and ensure all records are accurate Update provider and practitioners, facilities Hospitals and Clinics status to par by adding claims payment information with all provider data management including contracted and non-contracted provider data and other software programs.
Skills Required
HSGED. 3 yrs experience in the health care field interacting directly with providers. Good telephone demeanor. Must have previous experience with provider data, knowledge of medical terminology and medical providerpractitioner terminology.
Skills Preferred
Experience working with MediCal claims a plus. Associate Degree or certification in Healthcare processes a plus.