Provider relations Coordinator-OKC (277471-763)

Universal American Financial Corp. is a specialty health and life insurance holding company. Through our family of companies, we offer a broad array of health insurance and managed care products and services, primarily to the growing senior population. Universal American is included in the NASDAQ Financial-100 Index, the Russell 2000 Index and the Russell 3000 Index. For more information on Universal American, please visit our website at www.uafc.com Clerical Support is responsible for performing support functions in the Provider Relations Department.

Responsibilities and Duties:



-Perform intake triage and respond to network inquiries including provider requests (e.g., policy and procedures, credentialing status, claims status, provider leads, etc.). Internal customer requests & member requests

-Reports to management changes within the provider network

Provide telephonic education to providers on policies and procedures
-Obtains delegated credentialing materials and coordinates processes
-Support production and distribution of provider communication and educational materials
- ensures all contracts are reviewed and audited for accuracy; Coordinates all required approvals with appropriate parties

-Maintain contract files and is the liaison/single-point-of-contact for special projects, internal audit, core, provider service organization, and other functional areas for contract copies and information

-Acts as intermediary between Global Health and providers to record provider complaints and actively work to resolve provider issues i.e. claims, negative balance, correspondence, pended claim report, member complaint issue

-Ensures accuracy of the Provider Affiliations in the provider databases and submits system configuration requests
-Ensures providers submit accurate and up to date 1099 s
-Conducts accessibility monitoring of contracted provider offices on-site and after hours.
-Ensures accuracy of Provider Directories
-Acts as a resource to other PR team members, and represents PR Director at meetings, as required

-Provide telephonic education to providers on policies and procedures
-Obtains delegated credentialing materials and coordinates processes
-Support production and distribution of provider communication and educational materials

REQUIRED SKILLS
Requires logic and understanding to analyze problems and determine appropriate course of action.

Ability to handle multiple projects simultaneously

Understand basic mathematics. Ability to read, write and orally communicate at a level to correctly solicit/explain information.

PC skills including various types of software applications. Database experience preferred.

Can interact effectively with all levels within and across organizational lines.

Well organized

Prioritizes tasks effectively.

EDUCATION AND WORK EXPERIENCE:
Minimum of two years of experience as a Provider Services Representative or equivalent experience in a health care environment.

 

 

Please apply online:



 

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