Senior Managed Care Network Operations Specialist - REMOTE
About the position Responsibilities • Assist through site visits and presentations with physicians, hospitals, and ancillary providers. • Respond to credentialing application requests from payors. • Oversee claim, fee schedule, and contract language disputes. • Assist members in finding network providers and resolving payor/provider/member related issues. • Educate and update providers on Mercy's products and policies. • Maintain strong working relationships with payors and serve members effectively. • Oversee the duties of other Managed Care Network Operations Specialists. • Conduct site visits to self-funded employers and promote Mercy's services. Requirements • One year of managed care or health care experience desired, or 5 years of experience in lieu of a degree. • Bachelor's Degree or equivalent experience in managed care or health care. • Strong interpersonal and communication skills. • Ability to develop and maintain own schedule and prioritize assignments. Nice-to-haves • Understanding of physician office procedures and hospital operations. • Familiarity with medical terminology and health plan benefits. • Knowledge of medical coding. • Experience in filing/coding claims in a physician office, hospital, or insurance company. Benefits • Comprehensive health, vision, and dental coverage from day one. • Paid time off (PTO). • Tuition reimbursement. • Employer-matched retirement funds. Apply tot his job