Provider Engagement Specialist

A company is looking for a Senior Provider Engagement Network Specialist.

Key Responsibilities

Ensure accurate provider setup in the provider information system for state reporting and claims payment

Act as a liaison for provider networking and manage relationships with participating providers and groups

Research and resolve complex provider-related issues, including contract loading and claims data discrepancies

Required Qualifications

Bachelor's degree in a healthcare-related field or equivalent experience

5+ years of provider services experience in a managed healthcare environment

Experience with provider contracting and benefits interpretation

Knowledge of internal operations of provider relations

Ability to act as a subject matter expert in provider engagement