Field Provider Outreach Specialist

New York

Remote position available

Job Description

Supports 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

Title

Field Provider Outreach Specialist

Grade

22

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

5/8/2019

Date Requisition Created

5/8/2019

Minimum Qualifications

Education

Bachelors

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • 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.