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Provider Network Developer | Workers’ Compensation | Dental

  • Location: FL
  • Remote: Remote
  • Type: Questpro - Contingent
  • Job #20353

Network Developer for Workers' Compensation Dental Providers

Location:   Prefer Tampa or Jacksonville   
Work Set Up open to Hybrid or Fully Remote 
Competitive Pay + bonus and lots of room for advancement 

Job Description: 
Growing Managed Care company is looking for a Network Development Associate prefer to be located in either Tampa or Jacksonville, FL but open base on industry tech expertise to support our worker’s compensation administration teams. Company is patient-first specialty managed care company for injured workers focusing exclusively on above the neck injuries. We offer a generous benefit package including Medical, Dental and Vision benefits, paid time off, and opportunity for a 401K. We’re looking for talented and professional team members to provide superior customer care.
Roles and Responsibilities:

Identify dental and medical providers in lacking geographic locations to establish a sufficient network of participating providers to serve our clients.

Execute and review provider contracts, reimbursement rates, updates, and terminations received to ensure documents are accurate and complete.

Research and resolve provider-related matters and effectively handle and respond to account changes and correspondence.

Participate in audits of provider directory data to ensure accuracy of the information.

Seek, contact and negotiate single case or prepay agreements to fulfill gaps in contracted provider coverage as needed for the business.

Convert prepay providers to net terms as applicable.

Develop relationships with providers and offers feedback if there are deficiencies in their response time, scheduling time and/or providing medical documentation in a timely manner.
Required skills and abilities:

Understanding of the Workers Comp industry and ability to establish relationships with key administrators of new and participating group practices

Familiarity with various healthcare provider contractual documents, fee schedules, addenda, delegation agreements, and credentialing applications as required to contract new offices

Self-starter with the ability to convert insightful concepts into actionable tasks

Ability to interact effectively with Clinical, Finance and Operational teams for positive provider recruitment outcomes

Minimum 2 years of experience in network development, provider relations or medical/dental recruitment. Major plus if in a workers comp atmosphere.

Previous sales and customer service experience OR network management experience strongly preferred

Microsoft Office Applications

Bi-lingual is a plus

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