Job DescriptionSupports Clinical and Network requests, including research of provider criteria, verification of credentials and rate negotiation.
- Responsible for timely turnaround of agreements in accordance with the company and client standards.
- Communicates extensively (by telephone and email) with Providers, Network Field Management, and Customer Care on the status of reporting and network analysis trends and requests.
- Negotiates reimbursement rates with providers in accordance with set rate parameters.
- Analyzes and extracts information from various sources for use in locating providers.
- Researches provider status in all network systems and provide updated request for provider changes as needed.
- Provides support and training for provider outreach representatives as needed.
- Other duties as assigned by management.
General Job Information
TitleField Provider Outreach Specialist
Job FamilyOperations Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date5/8/2019
Date Requisition Created5/8/2019
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- 2+ years experience in a Customer Care/Healthcare environment with experience in eligibility, authorization and claims problem resolution.
- 2+ years experience in network development with demonstrated focus on contracting and rate negotiation.
- Excellent organizational and rate negotiation skills required.
- The ability to handle multiple tasks.
- Must be customer service oriented.
- Must be a team player.
- Must be able to maintain provider confidentiality at all times.
- Must demonstrate effective problem solving skills.
- Must have excellent verbal and writing skills.
- Must have working knowledge of Microsoft Office suite and data entry experience
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.