(Network Provider consultant -Claims/Policies/credentials)

Hello,

Innova Solutions is immediately hiring for a (Network Provider consultant-Claims / Policies / Credentials Specialist)

Position type : Fulltime / Contract

Duration : 17 months contract

Location : Chicago IL, Tulsa OK, ABQ New Mexico and Helena Montana

Work Mode : 100% Onsite

As a Network Provider consultant-Claims / Policies / Credentials Specialist), You will :

Job Description :

This position is responsible for analyzing, researching, and applying business rules to fulfill requests from providers regarding additions, deletions, and changes to their information used for claims processing, membership assignment, and directory purposes.

The role involves contracting, credentialing, and maintaining facility and professional provider data to support marketing and network contracting across all lines of business.

Key responsibilities include supporting the implementation of special projects, tracking various phases of projects, and managing workflow.

Additionally, this position assists management in training team members on business rules related to network contracting and credentialing.

The analyst will also identify gaps in processes and recommend strategies for improvement.

Key Responsibilities :

• Analyze and apply business rules for provider information updates.
• Contract, credential, and maintain provider data.
• Support special projects and manage workflow.
• Train team members on network contracting and credentialing.
• Identify process gaps and suggest improvements.

Required Job Qualifications :

• Bachelor’s degree plus 1 year of experience with provider network contracting and credentialing systems, or 5 years of experience in the healthcare industry.
• Strong written and verbal communication skills, including interpersonal skills.
• Ability to develop training materials and serve as an advisor to staff.
• Proficiency in Microsoft Office products, including analytical tools, and experience in developing reports.

Preferred Job Qualifications :

• Subject Matter Expert in the Professional Provider Credentialing Process.
• 2 years of experience with current government-sponsored health insurance networks.
• Knowledge of healthcare delivery systems, claim costing analytics, and provider network adequacy analytics.

We are currently interviewing to fill this and other similar positions. If this role is not a fit for you, we do offer a referral bonus program for referrals that we successfully place with our clients, subject to program guidelines. ASK ME HOW.

Thank you!

Anshima Chachondia

Associate Recruitment

7204521377

PAY RANGE AND BENEFITS :

Pay Range : $19 to $21 per hour

Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.

Benefits :

Innova Solutions offers benefits (based on eligibility) that include the following : Medical & pharmacy coverage, Dental / vision insurance, 401(k), Health saving account (HSA) and Flexible spending account (FSA), Life Insurance, Pet Insurance, Short term and Long term Disability, Accident & Critical illness coverage, Pre-paid legal & ID theft protection, Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

ABOUT INNOVA SOLUTIONS :

Founded in 1998 and headquartered in Atlanta, Georgia, Innova Solutions employs approximately 50,000 professionals worldwide and reports an annual revenue approaching $3 Billion.

Through our global delivery centers across North America, Asia, and Europe, we deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields.

Recent Recognitions :

• One of Largest IT Consulting Staffing firms in the USA Recognized as #4 by Staffing Industry Analysts (SIA 2022)
• Clearly Rated Client Diamond Award Winner (2020)
• One of the Largest Certified MBE Companies in the NMSDC Network (2022)
• Advanced Tier Services partner with AWS and Gold with MS

Website :

Innova Solutions is an Equal Opportunity Employer and prohibits any kind of unlawful discrimination and harassment. Innova Solutions is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates.

If you are an individual with a disability and need reasonable accommodation to assist with your job search or application for employment, please contact us at contact information .

Please indicate the specifics of the assistance needed. Innova Solutions encourages all interested and qualified candidates to apply for employment opportunities.

Innova Solutions (Hire Genics / Volt) does not discriminate against applicants based on citizenship status, immigration status, or national origin, in accordance with 8 U.S.C. 1324b.

The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

Thanks