Talent.com

Claim specialist [h1.location_city]

[job_alerts.create_a_job]

Claim specialist • colorado springs co

[last_updated.last_updated_1_day]
  • [promoted]
Network Management Specialist (Contract Specialist)

Network Management Specialist (Contract Specialist)

Magellan HealthColorado Springs, CO, US
[job_card.full_time]
The Network Contract Specialist will be responsible for creating and maintaining behavioral health provider contracts across the New Mexico territory for Presbyterian Health Plan with Medicaid, Med...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Parts Specialist

Parts Specialist

O'Reilly AutomotiveColorado Springs, CO, US
[job_card.full_time]
The actual hourly rate will equal or exceed the required minimum wage applicable to the job location.Additional compensation includes annual, quarterly performance, or premiums may be paid in amoun...[show_more][last_updated.last_updated_30]
Inventory Specialist

Inventory Specialist

Duane ReadeColorado Springs, CO, United States
[job_card.full_time]
Responsible for executing, monitoring, and training inventory best practices and standard operating procedures for the entire store, including both front end and pharmacy.Supports pharmacy inventor...[show_more][last_updated.last_updated_variable_days]
Claim Specialist - Property Field Inspection

Claim Specialist - Property Field Inspection

State Farm Mutual Automobile Insurance CompanyColorado Springs, Colorado, US
[job_card.full_time]
Location US-CO-Colorado Springs Job Category Claims and Investigation Position Type Regular Full Time Req ID 42764 Overview Being good neighbors – helping people, investing in our communities, and ...[show_more][last_updated.last_updated_30]
  • [promoted]
Sales Specialist

Sales Specialist

Home Depot (Retail)Colorado Springs, CO, US
[job_card.full_time]
Sales Specialists help customers bring their project ideas to life by offering a range of product options, providing samples, and recommending solutionsincluding installation and related services.S...[show_more][last_updated.last_updated_30]
  • [promoted]
Claim Specialist - Property Field Inspection

Claim Specialist - Property Field Inspection

State FarmColorado Springs, CO, United States
[job_card.full_time]
Being good neighbors - helping people, investing in our communities, and making the world a better place - is who we are at State Farm. It is at the core of how we operate and the reason for our suc...[show_more][last_updated.last_updated_30]
Delivery Specialist

Delivery Specialist

O'Reilly Auto PartsColorado Springs, CO, United States
[job_card.full_time]
Job Opportunity At Store 02918 Colorado Springs Co.The actual hourly rate will equal or exceed the required minimum wage applicable to the job location. Additional compensation includes annual, quar...[show_more][last_updated.last_updated_30]
  • [promoted]
Logistics Specialist

Logistics Specialist

Clearance JobsColorado Springs, CO, US
[job_card.full_time] +1
Links Technology is currently seeking a motivated and skilled Logistics Specialist to join our client's team with openings available in both Colorado Springs, CO and Parker, CO.Our client is a lead...[show_more][last_updated.last_updated_30]
  • [promoted]
Warehouse Specialist

Warehouse Specialist

Ace Hardware CorporationColorado Springs, Colorado, United States
[job_card.full_time]
This is combined with highly competitive : .Health insurance and much more!.T (Winning, Excellence, Love, Integrity, Gratitude, Humility, and Teamwork). You don't often see values like these in most c...[show_more][last_updated.last_updated_variable_days]
Logistics Specialist

Logistics Specialist

ClearanceJobsColorado Springs, CO, United States
[job_card.full_time]
Links Technology is currently seeking a motivated and skilled Logistics Specialist to join our client's team with openings available in both Colorado Springs, CO and Parker, CO.Our client is a lead...[show_more][last_updated.last_updated_30]
  • [promoted]
Billing Specialist

Billing Specialist

THRIVE HEALTH SYSTEMSColorado Springs, CO, United States
[job_card.full_time]
This is an excellent opportunity to get involved with the booming health & wellness industry, working with a leader in the natural healthcare space. We are a small, privately held asset management c...[show_more][last_updated.last_updated_30]
  • [promoted]
Warehouse Specialist

Warehouse Specialist

SkookumColorado Springs, CO, US
[job_card.full_time]
Tessera is seeking a Warehouse Specialist to join our dedicated team supporting operations at the United States Air Force Academy. In this role, you will play a vital part in receiving, storing, and...[show_more][last_updated.last_updated_30]
  • [promoted]
CLASS Specialist

CLASS Specialist

TeachstoneColorado Springs, CO, United States
[job_card.full_time]
Do you enjoy making a difference in a child's life, transforming education, and evolving learning? Come join Teachstone, the interaction company! Teachstone was founded in 2008 to deliver the Class...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Operations Specialist

Operations Specialist

Keller Executive SearchColorado Springs, CO, US
[job_card.full_time]
Eager to keep a global executive search firm running smoothly while supporting dynamic teams? Become our Office Coordinator at Keller Executive Search and excel in a vibrant, team-oriented atmosphe...[show_more][last_updated.last_updated_30]
  • [promoted]
Payroll Specialist

Payroll Specialist

Colorado StaffingColorado Springs, CO, US
[job_card.full_time]
Location : Colorado Springs, CO.Department : Financial Services.Closing Date : 12 / 14 / 2025 11 : 59 PM Mountain.Job Summary : As a Payroll Specialist for El Paso County, you are the powerhouse ensuring eve...[show_more][last_updated.last_updated_1_day]
Logistics Specialist

Logistics Specialist

JSfirmColorado Springs, CO, United States
[job_card.full_time]
DPP is seeking a Logistics Specialist for an opportunity in Colorado Springs, CO.Fully onsite in Colorado Springs, CO.Must be eligible to earn and maintain a US security clearance.As a Logistics Sp...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Billing Specialist

Billing Specialist

Adventure Learning Behavioral InterventionsColorado Springs, CO, US
[job_card.part_time]
Adventure Learning Behavioral Interventions.The Biller plays a crucial role in our operations, ensuring seamless financial processes and facilitating the accessibility of ABA, SLP, OT, and other th...[show_more][last_updated.last_updated_30]
  • [promoted]
Billing Specialist

Billing Specialist

Thrive Health SystemsColorado Springs, CO, US
[job_card.full_time]
This is an excellent opportunity to get involved with the booming health & wellness industry, working with a leader in the natural healthcare space. We are a small, privately held asset manageme...[show_more][last_updated.last_updated_30]
Advocacy Specialist

Advocacy Specialist

The Independence CenterColorado Springs, CO, United States
[job_card.full_time]
The Advocacy Specialist serves as the agency expert on advocacy and is responsible for following the board-approved systems' change activities at the local and state level.Assists Board and staff l...[show_more][last_updated.last_updated_30]
Network Management Specialist (Contract Specialist)

Network Management Specialist (Contract Specialist)

Magellan HealthColorado Springs, CO, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Network Contract Specialist

The Network Contract Specialist will be responsible for creating and maintaining behavioral health provider contracts across the New Mexico territory for Presbyterian Health Plan with Medicaid, Medicare, and Commercial lines of business. This role includes managing provider contracting activities in coordination with the Network team and processing all necessary contract-related updates. Key responsibilities include handling contract changes, Statements of Work, amendments, rate updates, Letters of Direction, and other required modifications. The specialist will also ensure all contract updates are compliant with internal policies and New Mexico-specific regulatory requirements. Strong collaboration with internal departments is essential to maintain network accuracy, provider data integrity, and overall operational efficiency. Detailed tracking and documentation of all contract activities and provider communications are critical components of this role.

Responsibilities include :

  • Support and maintain behavioral health provider contracts for Medicaid, Medicare, and Commercial lines of business across the New Mexico territory
  • Perform provider contracting functions in collaboration with the Network team
  • Process contract-related updates including : Exhibits, Contract changes, Statements of Work, Amendments, Rate updates, Letters of Direction, and NCQA / CAQH
  • Ensure compliance with internal standards and state-specific requirements
  • Collaborate with internal departments to support network accuracy, provider data integrity, and operational efficiency
  • Maintain thorough documentation and tracking of all contract activity and communications

Additional duties include :

  • Assess network needs, analyze network composition, and recruit individual, group, and / or organizational providers to meet network adequacy standards and assure quality network.
  • Conduct and coordinate contracting and amendment initiatives.
  • Provide issue resolution and complex troubleshooting for providers.
  • Conduct provider education and provider relation activities, providing necessary written materials.
  • Conduct administrative provider site visits and coordinate report development and completion according to contractual requirements or ad hoc requests.
  • Coordinate Public Policy Research Center activities to assure maintenance of current credentialing status, and evaluation and appropriate actions of quality of care issues and complaints against providers.
  • Conduct and manage ongoing audits of provider compliance with Magellan policies and procedures as well as contractual obligations for multiple customers. Develop work plans to address audit requirements.
  • Work with management to draft, clarify and recommend changes to policies which impact network management.
  • Other job requirements :

  • Knowledge of National Committee for Quality Assurance (NCQA) requirements.
  • Ability to work independently and prioritize activities.
  • Intermediate knowledge of Microsoft Office Suite, specifically Excel.
  • Strong presentation skills using PowerPoint.
  • Minimum of 1 year experience in related position / field.
  • General job information :

  • Title : Network Management Specialist (Contract Specialist)
  • Grade : 21
  • Work Experience - Required : Network
  • Work Experience - Preferred :
  • Education - Required :
  • Education - Preferred : Bachelor's
  • License and Certifications - Required :
  • License and Certifications - Preferred :
  • Salary Range :

    Salary Minimum : $45,655

    Salary Maximum : $68,485

    This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE / M / F / Vet / Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.