Provider Network Consultant

HCSC•Richardson, TX

60d

About The Position

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for developing and maintaining cooperative working relationships with the contracting provider community; educating, training, researching problems; and identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed. Ability and willingness to travel, including overnight stays.

Requirements

Bachelor's degree in health care or business administration or a minimum of 4 years work experience in a managed care environment.
Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
Effective interpersonal, analytical, presentation and communication skills.
Knowledge of the health care industry and BCBSIL private business.
Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
Extensive knowledge of contracts, applications, and products.
Demonstrated proficiency in provider reimbursement methods.
Working knowledge of claims processing systems.
Effective organizational and planning skills.
Ability to take initiative and work independently.
Demonstrated ability to meet deadlines and work well under pressure.
Working knowledge of software, including Microsoft Office

Responsibilities

developing and maintaining cooperative working relationships with the contracting provider community
educating
training
researching problems
identifying trends and evaluating providers to ensure contractual and financial requirements are adhered to and performed