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Provider Relations Specialist (Clinical Nurse Specialist #)

Company: WellPath
Location: Hendersonville
Posted on: November 10, 2019

Job Description:

Overview Our Provider Relations Specialist will maintain provider demographic records within the claims transaction system and will match existing member eligibility to incoming provider claims for proper processing. QualificationsEducation:

  • Must have high school diploma or GED Experience:
    • Experience with medical provider billing is helpful.
    • Must be proficient with Microsoft excel, Microsoft word and general typing skills.Licenses/Certifications:
      • None requiredResponsibilities
      • Creates and maintains provider demographic records in claims transaction system.
      • Updates W'9's in claims transaction system and notifies appropriate parties.
      • Reviews external preferred provider network data and updates claims transaction system.
      • Processes manual eligibility for correct provider submission.
      • Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.Wellpath is an EOE/Minorities/Females/Vet/Disability Employer Keyphrases: correctional medical services jobs, correctional medicine jobs, correctional health services jobs, prison health services jobs

Keywords: WellPath, Hendersonville , Provider Relations Specialist (Clinical Nurse Specialist #), Healthcare , Hendersonville, Tennessee

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