Network Management Rep

Elevance Health•Norfolk, VA

2d•$20 - $30•Hybrid

About The Position

The Network Management Rep provides comprehensive services to the provider community through researching more complex provider issues. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Requirements

Requires a H.S. diploma or equivalent and a minimum of 3 years of customer service experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills strongly preferred.

Responsibilities

Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction.
Researches and resolves the complex provider issues and appeals for prompt resolution.
Coordinates prompt claims resolution through direct contact with providers and claims department.
May perform periodic provider on-site visits.
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.
Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery.
Determines if providers were paid according to contracted terms.