NETWORK MANAGEMENT COORDINATOR
MINIMUM QUALIFICATIONS -Bachelor's degree in a related field -Healthcare provider experience (billing, claims, authorization, provider network relations, etc.),
SPECIALIZED KNOWLEDGE Use of Microsoft office products, including but not limited to Word, Excel, Outlook (email, calendar, and contacts), and PowerPoint. Excellent keyboarding skills. Can effectively communicate with professional offices. Ability to respond to common inquiries or complaints from peers, customers or members of the business community.
- Assist providers in all aspects of credentialing according to established guidelines.
- Coordinate with providers to obtain credentialing applications.
- Assist providers reimbursement rates/fee schedule upon request
- Advise appropriate internal departments regarding new provider information, and/or existing incorrect provider information, through accurate completion of provider change forms, or other acceptable change of provider information processes. Quality Customer Service to external and internal customers
- Respond to external and internal customers inquiries, and email according to departmental standards.
- Provider follow-up and feedback to appropriate departments on provider issues.
- Maintain professional comportment with all customers
- Actively participate in departmental and company staff meetings
- Follow-up within providers, or internal customers within two business days, or upon agreed upon date with those parties, on unresolved issues/questions. Support Network Management activities.
- Assist in provider network retention, to meet or exceed department goals.
- Audit provider data to ensure data accuracy.
- Communicate benefits of network participation to current and prospective network providers.
- Assist current and prospective network providers in credentialing and re-credentialing process.
- Prepares reports for PND Committee meetings.
- Prepares correspondence, creates reports and coordinates with other internal and external staff as necessary.