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Provider Network Specialist

Provider Network Specialist

VirtualVocationsRaleigh, North Carolina, United States
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A company is looking for a Provider Network Specialist.

Key Responsibilities

Provide information on eligibility, coverage, and procedures to clients and MCO covered injured workers

Collaborate with the Medical Director and vendors on physician credentialing and MCO network issues

Maintain MCO status and respond to client and injured worker inquiries regarding MCO issues

Required Qualifications

Bachelor's degree from an accredited college or university preferred

Four years of related experience, including three years in customer service and one year in analytical roles

Managed Care experience preferred

Thorough knowledge of MCO regulations, practices, and procedures

PC literate, including proficiency in Microsoft Office products

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Network Specialist • Raleigh, North Carolina, United States

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