Network Education Rep Senior

Elevance Health-posted 2 months ago
Full-time • Mid Level
Arcadia, WI
5,001-10,000 employees
Insurance Carriers and Related Activities
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The Network Education Rep Senior supports and maintains current provider network through customer service including training, credentialing assistance, claims resolution and advocacy. Develops and provides a standard orientation package for newly contracted providers. Promotes technology and skills development to improve provider business practices.

  • Provides/coordinates provider training for claims and billing procedures, contract compliance, medical management, and pharmacy issues.
  • Promotes provider compliance with local/state/region/federal regulations through provider forums and training opportunities.
  • Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations.
  • Facilitates provider network by recruiting necessary PCP, Specialist, Ancillary, and Hospital providers and assisting Network Support, Contracting, and Credentialing associates to credential and maintain accurate provider contract data.
  • Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies.
  • Mentors, coaches and trains lower level staff.
  • Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies.
  • Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background.
  • merit increases
  • paid holidays
  • Paid Time Off
  • incentive bonus programs
  • medical benefits
  • dental benefits
  • vision benefits
  • short and long term disability benefits
  • 401(k) + match
  • stock purchase plan
  • life insurance
  • wellness programs
  • financial education resources
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