Provider Relations Specialist I
- Employer
- CorVel Corporation
- Location
- Santa Ana, California
- Salary
- Not Specified
- Closing date
- Jun 8, 2019
View more
- Category
- Health and Medical
- Job Type
- Full Time
- Career Level
- Not Specified
Job Details
Job Summary :
CorVel is seeking a Provider Relations Specialist to work in our Santa Ana office. The Provider Relations Specialist assist injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls.
Essential Functions and Responsibilities :
- Receive incoming calls, emails and faxes from the Medical Access Assistant line
- Provide excellent customer service and act as network liaison to injured workers, claims examiners and providers
- Triage requests and ensure they are completed within required timeframes
- Locate providers of a particular specialty within a designated area as requested by the caller
- Verify providers are within a specified network and/or have a contract with CorVel
- Schedule appointments for injured workers upon request
- Follow all guidelines set by the California Code of Regulations
- Assist callers in navigating our website directory
- Call providers to verify demographic information (address, phone number, WC acceptance, etc)
- Answer questions from callers regarding their MPN; transferring the caller to the appropriate department if we are unable to assist
- Work with the Network Relations team to correct any discrepancies in the database
- Communicate to the contract developers if there is a need for certain specialties in a geographic area
- Multitask, utilize multiple programs and resources
- Various additional duties as assigned
Knowledge and Skills :
- Ability to write and speak clearly, easily communicating complex ideas across multiple platforms
- Ability to maintain composure in stressful situations and communicate diplomatically via telephone, fax, email or face to face interactions
- Ability to work independently and prioritize tasks
- Computer proficiency with the ability to utilize MS Office and other programs
- Effective quantitative, analytical and interpretive skills
- Strong interpersonal, time management and analytical skills.
Education and Experience :
- Knowledge of California Workers Comp regulations, not required
- Call center experience a plus but not required
Applicant Instructions
In order to provide equal employment and advancement opportunities to all individuals, employment decisions at CorVel will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law.
Please be aware that CorVel generally does not review all applications submitted in response to job openings posted on the Internet because of the large volume of responses.
Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.
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Company
CorVel is looking for passionate, motivated individuals to join our team of associates and help us be successful by making a positive impact within our organization and for our clients. If you are interested in joining CorVel, review our available opportunities and submit your resume as indicated by the application instructions.
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