Network Outreach Specialist

Responsibilities:

• Makes outbound validation calls to providers to ensure demographic practitioner details for each practice location for all our client’s networks.
• Contacts members regarding preventive health activities.
• Receives inbound service calls and provides accurate, complete information in response to provider inquiries, complaints, and problems in a timely fashion.
• Contacts provider offices to encourage ongoing education and dialogue on data management best practices to service member/patient needs and to attend scheduled orientation sessions and other educational and outreach activities.
• Conducts provider surveys and assessments as applicable.
• Acts as liaison with providers, members, and outside community resources.
• Handles PCP/PCD changes for members.
• Verification of PCP/PCD and member eligibility with Providers.
• Maintains call documentation in databases with relevant information regarding special outreach projects in accordance with departmental focus and objectives.
• Assists provider offices with issues associated with credentialing, recredentialing, claims, and provider data maintenance by providing guidance on how to proceed with the process.

Job Qualifications Education/Experience: High School Diploma/GED required.

Requires a minimum of 3 years of experience in customer service, telephone sales preferably in a Managed Care environment.

Some experience with provider practices, physicians, and/or office managers in a healthcare, group practice setting.

Knowledge:

• Prefers knowledge of our client’s products and services.
• Requires knowledge of the health insurance industry.
• Must be proficient in the use of personal computers and supporting software in a Windows-based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes.
• Should be knowledgeable in the use of intranet and internet applications.

Skills and Abilities:

• Requires excellent oral and written communication skills.
• Requires strong interpersonal and organizational skills.
• Requires the ability to resolve problems.

Since 1995, iTech Solutions Inc., has been providing IT Consulting and Direct Hire Services to the Insurance, Financial, Communications, Manufacturing, and Government sectors with local offices in Connecticut, Minnesota, Colorado, Massachusetts, Tennessee, North Carolina, and New Jersey / Pennsylvania area. Our recruiting strategy is simple, if you want to find qualified IT professionals then use IT professionals to find them. So at iTech Solutions, our personnel are all career IT professionals with a wide range of IT experience. We can honestly say our staff understands the technologies, the complexities of finding and selecting the appropriate personnel and the pressures of running successful IT projects. Employer will not sponsor applicants for any employment visas, at hiring or in the future, including but not limited to H-1B visas. Corp-to-Corp or subcontract personnel will not be considered for this position. iTech Solutions, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans, or individuals with disabilities.