Provider Network Specialist 2

Provider Network Specialist 2

BC Forward is looking for Provider Network Specialist 2 in Houston, TX 77043

Position Title: Provider Network Specialist 2

Locations: 1311 West Sam Houston Parkway North, #140, Houston, TX 77043
Anticipated Start Date: ASAP
Expected Duration: 2 Months
Job Type: Contract to Hire
Shift: 9 to 5 primarily could be longer if evening meetings
Pay Rate: $30.00/hr on W2
Need: IPA /Health Plan experience and Claims billing/coding knowledge


Job Description:
Perform duties to act as a liaison between providers, the health plan and Corporate. Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.

Face to face with providers meeting with them to review operational reports, projects, contracts ,quality and risk adjustment
To have 3 to 4 face to face visits a day in the field with providers and staff

Required Skills/Experience:
IPA /Health Plan experience
Provider facing

Preferred Skills/ Experience:
Operations
EMR Experience e
Practice Experience

Job Responsibilities:
Serve as primary contact for providers and act as a liaison between the providers and the health plan
Conduct monthly face-to-face meetings with the provider account representatives documenting discussions, issues, attendees, action items, and research claims issues on-site, where possible, and route to the appropriate party for resolution Receive and effectively respond to external provider related issues
Provide education on health plans innovative contracting strategies Initiate data entry of provider-related demographic information changes and oversee testing and completion of change requests for the network
Investigate, resolve and communicate provider claim issues and changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
Perform provider orientations and ongoing provider education, including writing and updating orientation materials Ability to travel

Education/Experience: Bachelors degree in related field or equivalent experience. Knowledge of health care, managed care, Medicare or Medicaid. Bachelors degree in healthcare or a related field preferred. Claims billing/coding knowledge preferred.5-7 years of experience

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 229321 when responding to this ad.

---