Network Outreach Specialist
Axelon
Job Title
Shift: Mon - Fri 8:30 -5 PM 9with Half hour unpaid lunch and 15 minute break in between time). Will be closed on Federal Holidays. Duration: 6 month contract (possible to extend) Location: 100% Remote (however will need to report to the Hopewell, NJ office to pick up Badge)
Responsibilities
Makes outbound validation calls to providers in order to assure of demographic practitioner detail for each practice location for all client networks. Contacts members regarding preventive health activities. Receives inbound services calls and provide accurate complete information in response to provider inquiries, complaints and problems within a timely fashion. Contact provider offices to encourage ongoing education and dialogue on data management best practices to service member/patient needs and to attend scheduled orientation sessions and other educational and outreach activities. Conducts provider surveys and assessments as applicable. Act as liaison with providers, members and outside community resources. Handle PCP/PCD changes for members. Verification of PCP/PCD and member eligibility with Providers. Maintain call documentation in databases with relevant information regarding special outreach projects in accordance with departmental focus and objectives. Assist provider offices with issues associated to credentialing, re credentialing, claims and provider data maintenance by providing guidance on how to proceed with the process.
Job Qualifications Education/Experience
High School Diploma/GED required. Requires a minimum of 3 years of experience in customer service, telephone sales preferably in a Managed Care environment. Some experience with provider practices, physicians and/or office managers in a healthcare, group practice setting.
Knowledge
Prefers knowledge of Client products and services Requires knowledge of health insurance industry Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus
Skills and Abilities
Requires excellent oral and written communication skills. Requires strong interpersonal and organization skills. Requires ability to resolve problems.
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