- Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction.
- Researches and resolves the more complex provider issues and appeals for prompt resolution.
- Coordinates prompt claims resolution through direct contact with providers and claims department.
- Provides assistance with policy interpretation.
- Researches, analyzes and recommends resolution of provider disputes, issues with billing, and other practices.
- Assists providers with provider demographic changes as appropriate.
- Responds to provider issues related to billing, pricing, policy, systems and reimbursements.
- Determines if providers were paid according to contracted terms.
- H.S. diploma
- Minimum of 3 years of customer service experience; one year experience as a Network Representative; or any combination of education and experience, which would provide an equivalent background.
- Ability to work in an inbound call center environment calls per day) preferred.
- Able to work M-F 10:00am - 6:30pm CST highly preferred.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable
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Network Management Representative II - Las Vegas, United States - Elevance Health
Description
Title: Network Management Representative II
Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.
The Network Management Representative II provides comprehensive services to the provider community through researching more complex provider issues.
How you will make an impact:
Minimum Requirements
Preferred Qualifications
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $24.89/hr. to $40.87/hr.
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
