PROVIDER NETWORK CONSULTANT
Company: w3r Consulting
Location: Tulsa
Posted on: October 14, 2024
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Job Description:
Description: This position is responsible for the analyzing,
researching, and applying business rules to complete requests
received from providers regarding adds/deletes/changes to their
information used for claims processing, membership assignment, and
directory purposes. This position is responsible for contracting,
credentialing and maintaining Facility / Professional provider data
to support marketing, network contracting across all lines of
business. This role involves supporting the implementation of
special projects, assisting with tracking of various phases of a
project and managing workflow. This position includes assisting
management in familiarizing and training team members with the
various business rules in network contracting and credentialing
across all lines of business. In addition is responsible for
identifying gaps in processes and suggesting process improvement
strategies.
Required Job Qualifications:
* Bachelor degree plus 1 year of experience with Provider Network
contracting and credentialing systems OR 5 years of experience in
the Health Care industry.
* Written and verbal communication skills including interpersonal
skills. Skills to develop training materials and act as an advisor
to staff
* Experience and proficiency inn Microsoft Office software products
including analytical tools. Experience developing reports.
Preferred Job Qualifications:
* Subject Matter Expert for the Professional Provider Credentialing
Process
* 2 years of experience with current government sponsored health
insurance networks
* Knowledge of health care delivery systems, claim costing
analytics, and provider network adequacy analytics
Keywords: w3r Consulting, Edmond , PROVIDER NETWORK CONSULTANT, Professions , Tulsa, Oklahoma
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