Broadpath Hiring for Provider Service Representative at Remote Full Time

Job Description

Innovative, Dynamic, Fast Pace and Collaborative, these are just some of the words that our employees use to describe us but hey – don’t just take it from us – become a part of BroadPath today and experience our Culture of Constant Connection. We are expanding our team and looking to hire a Provider Network Data Management Representative. Our Provider Network Data Management Representative is responsible for providing administrative support to various projects inclusive of updating provider database and/or credentialing requirements. You will ensure accuracy of high-volume data and maintenance of provider demographic and contract files.

Responsibilities

• Maintains current and validated provider demographics, networks, tax identification, 1099 data, Medicare certification and NPI data in the system with a high level of accuracy and meeting minimum productivity requirements
• Provides information to appropriate personnel regarding changes and updates in system support files
• Assist in educating providers, hospitals and the internal and external staff on demographic and network data requirements
• Identifies, assists, and resolves managed care issues concerning claims, contract interpretation, eligibility, and general provider demographic operational issues (aka credentialing)
• Assists internal departments in resolving provider and member appeals pertaining to the physician, ancillary providers and hospital network arrangements and plan contracts.
• Maintains accurate and current provider information and provides system support in provider network development.
• Assists with reporting network development needs in various geographic regions. Completes managed care contracts updates in the Impact system for payors and providers. Creates and processes required provider statistics and reporting.

Our Provider Network Data Management Representative will love the following benefits & perks!

• Pay Rate/ Salary $17 -$19 Hourly Based on Experience
• Invitation to join our Inclusivity, Diversity, Equity, + Action Committee
• Access to BroadPath’s PTO, Paid Holidays, and Our Major Medical Plan starting first of the month after 60 days of employment. After one (1) year of full-time employment, you will receive access to our 401K and our one of a kind “Bhive Kit;” which includes a camera that allows you to join our Connected Culture!
• Uncapped Employee Referral Program & Weekly Pay

Basic Qualifications

• Must have a minimum of 2 years credentialing experience
• Minimum of one year of provider network planning, process management or operations experience
• Must understand managed care reimbursement strategies and methodologies for physicians, hospitals, and ancillary providers
• Excellent analytical and problem-solving skills with keen attention to detail.

Preferred Qualifications

• Bachelor’s degree in business, healthcare administration, or related field
• One year of medical claims auditing and or provider data demographic processing experience and an understanding of medical terminology and knowledge of CPT-4 and ICD-9 coding