Location: Trenton,NJ, USA
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.Serve as primary contact for providers and act as a liaison between the providers and the health planConduct monthly face-to-face meetings with the provider account representatives documenting discussions, issues, attendees, action items, and research claims issues on-site, where possible, and route to the appropriate party for resolutionReceive and effectively respond to external provider related issuesProvide education on health plan's innovative contracting strategiesInitiate data entry of provider-related demographic information changes and oversee testing and completion of change requests for the networkInvestigate, resolve and communicate provider claim issues and changesEducate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topicsPerform provider orientations and ongoing provider education, including writing and updating orientation materialsAbility to travelPerforms other duties as assignedComplies with all policies and standardsEducation/Experience: Bachelor's degree in related field or equivalent experience. 0-2 years of provider relations or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Bachelor's degree in healthcare or a related field preferred. Claims billing/coding knowledge preferred.Licenses/Certifications: Current state driver's license.Pay Range: $22.36 - $38.07 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act