CorVel Corporation · 3 days ago

Network Relations Specialist I

Lawrenceville, GA

Full-time

Onsite

Entry Level

$15.98/hr - $25.69/hr

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Insider Connection @CorVel Corporation

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Responsibilities

Assist Developer with implementing medical providers through use of correspondence and telephonic contact.

Verify all provider signatures, contracts and documentation before submitting for internal processing.

Review credentials of prospective providers to be considered for acceptance into network per national credentialing requirements and protocols.

Provide orientation on managed care procedures and establish liaison(s) with all participating providers.

Assist and communicate a provider orientation program in cooperation with Developer.

Distribute and maintain provider manual and orientation materials per state guidelines.

Receive and resolve all disputes involving provider contract and payment issues in accordance with contract Dispute Resolution Procedures.

Oversee distribution of executed contracts and maintenance of database.

Conduct and manage provider data audits that ensure data integrity for network and oversee all provider updates and changes with NDB.

Coordinate and process provider roster updates regularly and as appropriate.

Maintain a professional appearance.

Requires regular and consistent attendance.

Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).

Additional projects and duties as assigned.

Qualification

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Insurance Industry KnowledgeManaged Care KnowledgeComputer ProficiencyMS OfficeExcel SpreadsheetsProblem-SolvingInterpersonalTime ManagementOrganizationalTeamwork