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- The incumbent will maintain current provider data for the largest, most complex account structures and maintain provider data to ensure the quality of the network. This position coordinates provider contract enrollment, distribute provider education, maintain repository for all provider service agreements and update directories for all contracted organizations.
- Act as a subject matter expert) for Provider demographic loading into all Cigna-Health Spring systems.
- Act as a subject matter expert for new provider education and onboarding.
- Conduct provider outreach via outbound calls, fax blasts, email requests and USPS mail for ad hoc compliance requirements.
- Act with a sense of urgency to research questions or issues raised by internal or external customers.
- Intake provider data from multiple sources
- Identify the right parties or resources, internally and externally, to resolve issues timely.
- Provide support for questions and issues raised by staff and provide answers as quickly as possible – supporting the timeliness of the review or outreach.
- Responsible for the loading of Provider Service Agreements into Tract Manager.
- Resolve issues and complete work within established CMS timeframes, ensuring compliance.
Qualification & Experience:
- Strong analytical and problem-solving skills.
- Strong knowledge of healthcare insurance industry, terminology, provider networks, contracting and credentialing.
- Knowledge of provider onboarding process, system applications and procedures
- Excellent communication skills – verbal, written and presentation.
- Ability and willingness to share knowledge.
- Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).
- Act with a sense of urgency to research questions or issues brought by the team. Identify the right parties or resources to resolve these issues. Follow up with these parties to drive resolution and provide on-going feedback to individual(s) who raised the question or issue.
- Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
- High school degree or equivalent experience
Vacancy Type: Full Time
Job Location: Birmingham, AL, US
Application Deadline: N/A