Contract length: 10/29/18 - 9/28/19
Hours: M-F 7:00am - 3:30pm
Pay Rate: $16/hr
Track record of prioritizing work, multi-tasking, and managing workload efficiently.
Education and Certification Requirements
• College degree or equivalent work experience preferred.
Additional Information (situational competencies, skills, work location requirements, etc.)
• Possesses a working knowledge of Intuit Quickbase, MS Excel, Outlook, Word a plus
• Knowledge of managed care business and healthcare environment a plus
This position may or may not have dual responsibilities meaning phone experience and loading contracts.
• Establish/maintain and align contracted provider demographic data and negotiated reimbursement arrangements across provider systems
• Review new and existing contract reimbursement arrangements for compliance with standards and determine most appropriate system input methodology that facilitates accurate and consistent claim adjudication
• Maintain cooperative working relationships with internal Aetna contacts
• Analyze, identify and report on significant changes to network configuration and market information
• Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination.
• Extract information from provider systems to meet business reporting needs
• Performs credentialing support activities as needed.
• Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.
• May collaborate cross-functionally on the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
• Conduct standard provider recruitment, contracting, or re-contracting activities and assist with more complex contracting and discussions as needed by business segment.
• May provide guidance and training to less experienced team members.
In the rapidly changing, highly regulated industry that is healthcare, you need a medical staffing partner who works for you.
Enter TotalMed. We’re an award-winning medical staffing agency delivering flexible healthcare staffing solutions no matter how complex your needs. But even more than that, we’re a team who really cares. Our end goal is to achieve quality patient care while enhancing your employee morale.
If you’re a healthcare professional in either clinical or non-clinical healthcare, our recruiters can help you navigate the sea of healthcare jobs, uncovering your ideal career path.
Or, if you’re faced with open positions and short-staffed projects in either business care or patient care, TotalMed can provide customized medical staffing solutions to fulfill your hiring requirements.
Role: Providers Representative/Senior CSR (Healthcare)
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