CorVel's office in Jacksonville, FL is hiring for a network relations position. This position is the frontline of Network Development, responsible for providing excellent customer service while impacting and overseeing provider data integrity. This individual must combine strong interpersonal skills with an aptitude in the medical provider market.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Assist Developer with implementing medical providers through use of correspondence and telephonic contact.
- Verify all provider signatures, contracts and documentation before submitting for internal processing.
- Review credentials of prospective providers to be considered for acceptance into network per national credentialing requirements and protocols.
- Provide orientation on managed care procedures and establish liaison(s) with all participating providers.
- Assist and communicate a provider orientation program in cooperation with Developer.
- Distribute and maintain provider manual and orientation materials per state guidelines.
- Receive and resolve all disputes involving provider contract and payment issues in accordance with contract Dispute Resolution Procedures.
- Provide assistance and be responsive to staff requests for assistance, information regarding the network, both locally and nationally.
- Oversee distribution of executed contracts and maintenance of database.
- Assist with network marketing, employer and payor relations and product development.
- Conduct and manage provider data audits that ensure data integrity for network and oversee all provider updates and changes with NDB.
- Coordinate and process provider roster updates at least annually or as otherwise required.
- Perform facility site surveys as needed per credentialing requirements or state guidelines.
- Identify anemic specialties within network and generate a recruitment list for Developer.
- Requires regular and consistent attendance.
- Maintain a professional appearance.
- Additional duties as assigned.
KNOWLEDGE & SKILLS:
- Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative
- Ability to continually adapt daily routines that allow each function to be manageable.
- Ability to properly prioritize and manage assignments, scheduled or unscheduled
- Ability to embrace new tools and procedures per corporate guidelines and objectives.
- Strong organizational skills
- Excellent written and verbal communication skills
- Superb attention to detail and ability to deliver results in a fast paced and dynamic environment.
- Associate's degree or two or more years equivalent work experience
- Expertise in FL managed care arrangement
- Proficient in Microsoft applications
- Customer service education/training within the insurance industry, managed care or related field
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publically traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.