Provider Network Specialist at NationsBenefits (Miami, FL)
At NationsBenefits, we are a fast-paced, rapidly growing company seeking hundreds of new employees for various roles in our six locations across the Nation.
It all begins with how we care about the people we serve. Since 2015, our mission has guided our principles towards delivering solutions for a rapidly changing industry. Compassionate Care is at the center of all we do, and it unites us to foster an environment where everyone is empowered, inspired, and equipped for success.
We offer a fulfilling work environment that attracts top talent and encourages all associates to do their part in delivering best-in-class service to internal and external customers alike. It’s how we’re transforming the healthcare industry for the better. We provide career advancement opportunities from within the organization with multiple locations in Florida, California, Tennessee, Pennsylvania, Utah, and India.
Together, we can make a meaningful and measurable difference in the lives of millions. That’s something we can all be proud of.
Compensation for all positions is competitively higher than the current marketplace. Simply put - we pay more. We also show our gratitude through supplemental pay, including overtime, raises, and performance bonuses. You can earn even more through referral bonuses. We also offer a comprehensive benefits package including medical, dental, vision, life, disability, 401(k) and paid holidays/time off for eligible employees. We invest in the employee experience through training and development opportunities. Achieve your potential and grow your career with NationsBenefits.
This position identifies, contracts and maintains relationships with participating providers within assigned geographic territory. This position is responsible for the appropriate representation of providers relating to contractual requirements, reimbursement, compliance, credentialing and provider registration policy and procedures. Work closely with key internal functional teams to ensure successful implementation of provider agreements from initiation to approval, including provider credentialing, provider data management, and orientation. This position requires excellent interpersonal skills to communicate effectively. They must be a positive, energetic individual with strong organizational skills, attention to detail and ability to multi-task. Basic to intermediate knowledge of excel is required.
- Develop and retain effective relationships with providers and administrative staff of targeted provider groups within assign geographic territory
- Initial contact with providers/provider groups in a specified geographical territory serving as the primary contact for contracting, billing and reimbursement inquiries
- Monitor the contracting process to ensure contract administration objectives are achieved as well as the provider data registration process is completed successfully
- Assist with the network development strategies to support patient access & availability and membership growth of health plan partners
- Understanding of how hearing aid/audiology provider practices operate and how NationsHearing policies may impact or be impacted by this structure and understanding of various reimbursement methodologies and how it relates to cost
- Complete outbound calls to potential providers to invite them to participate in the network
- Respond to provider inquiries, concerns or complaints related to the onboarding process
- Effectively manage follow up calls and email
- Maintain lead records with status details and outreach communication efforts
- Initiate, complete, submit, and track agreements, registrations and\or applications
- Monitor email boxes and other sources of incoming data notifications to ensure that onboarding process is completed in a timely manner
- Maintain both electronic and hard copies of provider agreements, registrations and or applications
- Synthesize and report on data related to outreach and onboarding of new providers
- Coordinate with Data Management Specialist to reconcile data gaps between our system and agreements, registration and\or applications
- Create presentations as needed
- Special Projects as needed
- Provider overflow duties, as requested
- Other duties as may be assigned
- Bachelor’s Degree
- Provider Network Development
- Knowledge, Skills and Abilities
- Creative mindset
- Basic to intermediate knowledge of Microsoft Applications
- Quick learner and self-motivated
- Ability to work as a team member or independently
- Calm under pressure
- Strong problem-solving skills
- Professional presentation and demeanor
- Availability to work after normal business hours including weekends and holidays, when needed
NationsBenefits is an Equal Opportunity Employer.