Supports the Provider Relations Field Representative to achieve department goals. Answer incoming telephone inquiries from providers and assist with problem resolution of issues. Coordinate submission of provider to internal departments via contract maintenance forms.
- Supports the Provider Relations Field Reps to resolve claims and payment issues.
- Answers incoming telephone inquiries from providers and assist with problem resolution of issues.
- Root cause analysis of operational and health services issues.
- Reviews and processes incoming and outgoing paperwork, including directory updates, provider credentialing applications, contract maintenance forms and other related forms.
- Tracks new contracts through sidewinder.
- Audits configuration loads on new contracts.
- Provides office, project management, provider recruitment and data analysis support.
- Special Projects as assigned or directed.
This position is contingent upon the bid award in the state of Illinois to WellCare Health Plans, Inc.
Education: Associate's Degree preferred.
Experience: 1 years experience in customer service or claims with exposure to problem resolution.
- Excellent problem solving skills.
- Excellent oral and written communication skills.
- Must be organized and have excellent time management capabilities.
- Ability to analyze data to identify trends, and variance from goals.
Technical Skills:Proficiency with Microsoft Outlook, Word, and Excel.