(Archived) Correctional Medicine Provider Relations Specialist Needed in Hendersonville, TN

Here at Wellpath, everything that we do is about taking care of people – our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives in an autonomous environment, is empowered and supported by education, training and the resources to practice healthcare the way it is meant to be and strives to “Always Do The Right Thing!”

Our Provider Relations Specialist will maintain provider demographic records within the claims transaction system and will match existing member eligibility to incoming provider claims for proper processing.

Education:

• Must have high school diploma or GED

Experience:

• Experience with medical provider billing is helpful.
• Must be proficient with Microsoft excel, Microsoft word and general typing skills.

Licenses/Certifications:

• None required

1. Creates and maintains provider demographic records in claims transaction system.

2. Updates W’9’s in claims transaction system and notifies appropriate parties.

3. Reviews external preferred provider network data and updates claims transaction system.

4. Processes manual eligibility for correct provider submission.

5. Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.

6. Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations.

7. Must be alert at all times; pay close attention to details.

8. Must be able to work under stress on a regular or continuous basis.

9. Perform other duties as assigned.

Wellpath is an EOE/Minorities/Females/Vet/Disability Employer