Job added in hotlist
Applied job
Contract job
90-day-old-job
part-time-job
Recruiter job
Employer job
Expanded search
Apply online not available
Similar Jobs
Network Coordinator
Becker Technical Staffing, Inc.
Philadelphia, PA
Apply Now >
Network Coordinator
HCS Healthcare
Philadelphia, PA
Apply Now >
Telecom Project Engineer
Jacobs Entertainment Inc
King of Prussia, PA
Apply Now >
OfficeSuite/Ucaas Repair Technician I
Windstream Communications.
King of Prussia, PA
Apply Now >
Telecommute Senior Network Engineer
Virtual Vocations
Philadelphia, PA
Apply Now >
View more jobs in Philadelphia, PA
View more jobs in Pennsylvania
View Similar Jobs

Job Details

Network Coordinator

Company name
Apex Systems, Inc.

Location
Philadelphia, PA
2 hit(s)  

Profile

\u003Cp\u003E\u003Cb\u003EAPEX Systems is seeking a Network Coordinator for a well-known healthcare client in Philadelphia, PA. I you feel your skills align with the job description below please email Technical Recruiter, Jayme Polito, at \u003Ca href=\mailto:jpolito@apexsystems.com\\u003Ejpolito@apexsystems.com\u003C/a\u003E. \u003C/b\u003E\u003C/p\u003E\u003Cp\u003E\u003Cb\u003EProvider Network Services\u003C/b\u003E\u003C/p\u003E\u003Cp\u003E\u003Cb\u003EDescription:\u003C/b\u003E\u003C/p\u003E\u003Cul\u003E\u003Cli\u003EThe Provider Network Services Account Team Network Coordinator is responsible for servicing a defined segment of high-profile professional, hospital, and ancillary providers and integrated delivery systems in Pennsylvania and Delaware, and is the single point of contact for both entry and exit of all issues.\u003C/li\u003E\u003Cli\u003EIndependently organizes and conducts regular (at least monthly) meetings with these providers.\u003C/li\u003E\u003Cli\u003EIndependently researches and analyzes the issues that impact these providers, including but not limited to issues regarding claim payments, provider data file discrepancies, Quality Incentive Payments (QIPS), capitation, medical policy, utilization management, and other compliance initiatives.\u003C/li\u003E\u003Cli\u003EConducts root cause analysis and works collaboratively with staff in other business areas to assist with the resolution of complex provider issues and achieve expected goals/outcomes within established timeframes.\u003C/li\u003E\u003Cli\u003EMaintains and updates the appropriate tracking issues database with current statuses and next steps.\u003C/li\u003E\u003Cli\u003EUses the information gained during servicing activities to make recommendations to management regarding the identification of significant opportunities to improve operational efficiency, reduce costs and improve provider satisfaction.\u003C/li\u003E\u003Cli\u003EEducates providers on new initiatives and changes in medical and claims payment policy and related operational procedures.\u003C/li\u003E\u003Cli\u003EWorks collaboratively with Contracting and Reimbursement to support decisions and negotiations during the recontracting process.\u003C/li\u003E\u003Cli\u003EEstablishes and maintains professional and effective relationships between IBC and these providers to continually improve provider satisfaction\u003Cb\u003E. \u003C/b\u003E\u003C/li\u003E\u003C/ul\u003E\u003Cp\u003E\u003Cb\u003EMajor Activities: \u003C/b\u003E\u003C/p\u003E\u003Cp\u003E1. Services a defined segment of high-profile professional, hospital, and ancillary providers and integrated delivery systems in Pennsylvania and Delaware via on-site visits, provider telephone calls or written correspondence.\u003C/p\u003E\u003Cp\u003E2. Independently organizes and conducts initial orientations and routine meetings with these providers.\u003C/p\u003E\u003Cp\u003E3. Independently researches and analyzes the issues that impact these providers, including but not limited to issues regarding claim payments, provider data file discrepancies, Quality Incentive Payments (QIPS), capitation, medical policy, utilization management, and other compliance initiatives.\u003C/p\u003E\u003Cp\u003E 4. Conducts root cause analysis and works collaboratively with staff in other business areas to assist with the resolution of complex provider issues and achieve expected goals/outcomes within established timeframes, requesting the support of management when needed.\u003C/p\u003E\u003Cp\u003E5. Maintains and updates the appropriate tracking issues database with current statuses and next steps. Keeps the provider informed on progress of issue(s) from receipt to closure.\u003C/p\u003E\u003Cp\u003E 6. Uses the information gained during servicing activities to make recommendations to management regarding the identification of significant opportunities to improve operational efficiency, reduce costs and improve provider satisfaction.\u003C/p\u003E\u003Cp\u003E7. Proactively identifies policy and procedural issues and recommend potential resolutions by working with core areas within organization.\u003C/p\u003E\u003Cp\u003E8. Educates providers concerning new initiatives and changes in medical and claims payment policy and related operational procedures. Makes recommendations to management regarding changes to policy and procedures based on direct input from the provider community and information gathered regarding standard industry practices.\u003C/p\u003E\u003Cp\u003E9. Establishes and maintains professional and effective relationships with assigned providers to promote improvements in provider satisfaction and compliance with contractual obligations, applicable State \u0026amp; Federal regulatory requirements, accreditation standards, and corporate policies.\u003C/p\u003E\u003Cp\u003E10. Works collaboratively with Contracting and Reimbursement to support decisions and negotiations during the recontracting process.\u003C/p\u003E\u003Cp\u003E11. Develops and maintains professional and effective relationships with key functional areas within IBC; represents manager on corporate workgroups, as assigned.\u003C/p\u003E\u003Cp\u003E12. Supports others members of the Account Team to ensure that service levels and goals are met.\u003C/p\u003E\u003Cp\u003E13. Completes assigned projects to support corporate initiatives within the timeframe set by Management.\u003C/p\u003E\u003Cp\u003E\u003Cb\u003ERequirements:\u003C/b\u003E\u003C/p\u003E\u003Cul\u003E\u003Cli\u003EThe candidate must have a Bachelor\u0026rsquo;s degree or equivalent work experience.\u003C/li\u003E\u003Cli\u003EMinimum five years\u0026rsquo; progressive experience in a health-care related organization is required, with experience in Provider Networks, Contracting, Claims Processing or Managed Care Operations strongly preferred.\u003C/li\u003E\u003Cli\u003EKnowledge of professional and facility billing requirements, reimbursement methodology, IBC/AHDE products and benefits, and Blue Card.\u003C/li\u003E\u003Cli\u003EProficiency with Word, Excel, Access, and Outlook.\u003C/li\u003E\u003Cli\u003E Experience using multiple IBC systems including OSCAR, CPR, INSINQ and 4UM.\u003C/li\u003E\u003Cli\u003EProven ability to conduct educational programs using a multi-media approach to small and large groups.\u003C/li\u003E\u003Cli\u003EPrior experience in a service-oriented role strongly preferred.\u003C/li\u003E\u003Cli\u003EThe candidate must be self-motivated with strong interpersonal, analytical, problem-solving, organizational, and written and verbal communications skills.\u003C/li\u003E\u003Cli\u003EAbility to independently manage multiple priorities and customer expectations to a successful conclusion with limited supervision is essential, as is the ability to interact effectively with all levels of management, including medical directors.\u003C/li\u003E\u003C/ul\u003E\u003Cp\u003EEEO Employer\u003C/p\u003E\u003Cp\u003EApex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at \u003Ca href=\mailTo:employeeservices@apexsystemsinc.com\\u003Eemployeeservices@apexsystemsinc.com\u003C/a\u003E or 844-463-6178.\u003C/p\u003E\u003Cbr\u003E\u003Cdiv\u003EVEVRAA Federal Contractor\u003C/div\u003E\u003Cdiv\u003EWe request Priority Protected Veteran \u0026 Disabled Referrals for all of our locations within the state.\u003C/div\u003E\u003Cdiv\u003EWe are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. The EEO is the Law poster is available \u003Ca href=\http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf\ target=\_blank\\u003Ehere.\u003C/a\u003E\u003C/div\u003E,datePosted:2018-05-16,employmentType:FULL_TIME,industry:Information Technology,hiringOrganization:{@type:Organization,name:Apex Systems, Inc.},identifier:{@type:PropertyValue,name:Apex Systems, Inc.,value:849141},jobLocation:{@type:Place,address:{@type:PostalAddress,addressCountry:US,streetAddress:,addressLocality:Philadelphia,addressRegion:PA,postalCode:19101}}}

Company Profile

Similar Jobs:
Entry Level Telecommunications Associate
Location : Pennsauken, NJ
Are you looking for an exciting opportunity in a fast-growing industry? Do you want to make a difference in people's lives while you grow your career and learn the business? We're BAYADA Home Health Carea leading home health care ...
May 20, 2018 Job Description What are we looking for? We are currently looking for a full-time Territory Sales Representative to join our team working on an exciting new business development project. The ideal candidate will be dy...
Installation and Maintenance Technician
Location : Laurel Springs, NJ
Job Description Salary Information Weekly Rate: $961.50 - $1373.50 Summary Located in both field and operations support center locations, you will perform complex technical duties working in LD Terminals, customer premises, Loc...
EmploymentCrossing was helpful in getting me a job. Interview calls started flowing in from day one and I got my dream offer soon after.
Jeremy E - Greenville, NC
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
TelecomCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
TelecomCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2018 TelecomCrossing - All rights reserved. 168