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<http://schema.org/description>
"&lt;p&gt;&lt;span&gt;You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;/p&gt;Position Purpose: 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.&lt;p&gt;&lt;/p&gt;&lt;p&gt;&lt;/p&gt;• Serve as primary contact for providers serving as a liaison between the provider and the health plan&lt;br&gt;• Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on •site and routing to the appropriate party for resolution&lt;br&gt;• Receive and respond to external provider related issues&lt;br&gt;• Initiate entry or change of provider related database information and oversee testing and completion of change request&lt;br&gt;• Investigate, resolve and communicate provider claim issues and changes&lt;br&gt;• Educate providers regarding policies and procedures related to referrals and claims submission, web site education, EDI solicitation and problem solving&lt;br&gt;• Perform provider orientations, including writing and updating orientation materials&lt;br&gt;• Ability to travel&lt;p&gt;&lt;/p&gt;&lt;p&gt;&lt;/p&gt;&lt;p&gt;Education/Experience:&lt;/p&gt;&lt;ul&gt;&lt;li&gt;Bachelor’s degree in related field or equivalent experience.&lt;/li&gt;&lt;li&gt;0-2 years of provider relations or contracting experience.&lt;/li&gt;&lt;li&gt;Knowledge of health care, managed care, Medicare or Medicaid.&lt;/li&gt;&lt;li&gt;Bachelor’s degree in healthcare or a related field preferred.&lt;/li&gt;&lt;li&gt;Claims billing/coding knowledge preferred.&lt;/li&gt;&lt;/ul&gt;&lt;p&gt;&lt;br /&gt;Licenses/Certifications: Current state driver’s license.&lt;br /&gt;&lt;br /&gt;For South Carolina only - Current state driver&#39;s license preferred.&lt;/p&gt;&lt;p&gt;&lt;/p&gt;&lt;p&gt;Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.&lt;/p&gt;&lt;p&gt;&lt;/p&gt;&lt;p&gt;Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.&lt;/p&gt;"
<https://jobs.centene.com/us/en/job/1325890/Provider-Network-Specialist-I>