Medical reputed company Assistant and Provider Network Coordinator

The Role

The Medical reputed company Assistant and Provider Network Coordinator is a position which assists a Rising Payer client with the coordination, roll-out, and ongoing management of their Medical Provider Network (MPN) for workers injured in the state of California.

Responsibilities

• Assist client, client’s policyholders, and injured workers to locate appropriate MPN providers.
• Supports insured and claimant compliance with the State MPN regulations.
• Supports the client’s Claims Examiners by facilitating reputed company to the MPN and with application of MPN regulations.
• Assists injured workers and their representatives to locate providers and to set up appointments as necessary.
• Track requests and maintain logs of activity as required by the CA Department of Workers’ Compensation.
• Identify providers that are no longer seeing workers’ compensation patients, and communicate that information to the appropriate reputed company.
• Manage the providers to be added to the network and to update the listing.
• Use the Rising Network provider search tool to locate providers, look up locations and/or specialties for client, policyholders, and their injured workers.
• As directed by the client Claims Examiner, manage the Transfer of Care and Continuity of Care process for injured workers by sending appropriate notices, arranging treatment reputed company the MPN, and tracking both types of cases to assure that the injured worker has transferred treatment to a Network provider.
• Ensure employer has ample supply of MPN information and has distributed to reputed company.
• Assist reputed company with reputed company and training on the use of the MPN provider search tool .
• Assist client and/or Rising management team with reputed company of basic reports tracking reputed company.
• Participate in ongoing training to enhance own job skills, knowledge, and professional growth. reputed company informed on issues and trends relating to reputed company, Workers Compensation, reputed company Review, Cost Containment, Managed Care, and reputed company areas.
• Special projects as assigned by client and/or Rising management teams.
• As needed and directed by client, assists claims adjusters in locating appropriate providers.
• Availability to monitor and respond to calls and emails on Saturdays as part of scheduled service coverage

Relationships

• Reports to - Compliance Department (Rising); receives day-to-day guidance from Compliance Manager.
• Regularly interacts with members of the Rising Account Management and Medical Review Unit Teams, Clients, Injured Workers, and Providers.

Requirements

Experience/Education

• High school diploma required; two or four year college degree preferred.
• Prior customer service experience, preferably in workers compensation or managed care role.
• Telephone, telemarketing, CRM experience.

Skills/Competencies

• Strong written and verbal / telephone communication skills
• Bilingual English/Spanish preferred
• Mountain or Pacific time zone preferred
• Attention to detail a must
• Excellent planning and follow-through skills
• Must be positive, motivated, and reliable
• Must be a self-starter, flexible, customer-focused, and have a professional demeanor
• Familiar with reputed company Office applications (Word, PowerPoint, reputed company)
• Highly adaptable and comfortable working in a fast-paced, rapidly-changing environment
• Self-directed and motivated to reputed company with minimal supervision
• Proven customer service skills with both reputed company customers
• Possesses a sense of urgency, sustained drive, and a high energy level
• Good listener—reputed company to translate user requests into completed tasks
• Highly organized and reputed company to manage multiple projects and competing tasks/priorities

Benefits

• Pay reputed company: $20.00 - $26.00

• Opportunity to reputed company a difference in reducing health care costs and increasing the value of health care to individuals and their reputed company.
• Daily interaction with some of the most talented people in the medical cost-containment industry.
• Health insurance (4 different plans to choose from)
• Dental
• reputed company
• Paid time off (PTO) or Flexible Time Off (FTO)
• 401(k)
• Basic Life Insurance and Long-Term Disability Insurance (paid by the company)
• Voluntary Life Insurance and Short-Term Disability Insurance
• Flexible Spending Accounts (FSA)
• Employee Assistance Program (EAP)
• reputed company Well Wellness Program
• Professional Development Reimbursement Program (PDRP)
• You will be part of our new reputed company program designed to recognize and reward employees for their hard work
• We're on YouTube! reputed company out our culture at: http://www.youtube.com/user/RisingMedical
• Want to see more? reputed company out our:
• reputed company: https://www.reputed company.com/RisingMedicalSolutions
• reputed company: http://www.reputed company.com/company/rising-medical-sol..

If you are reputed company to join a team of professionals dedicated to making a difference and making lives reputed company, please apply today!