More Than 100 Years of Earning Trust
Network Outreach Specialist I
Location
New Jersey
Posted
2 days ago
Salary
$50.1K - $67.1K / year
Seniority
Senior
Job Description
Network Outreach Specialist I
NJM Insurance Group
• Makes outbound validation calls to providers in order to assure of demographic practitioner detail for each practice location for all Horizon networks. • Contacts members regarding preventive health activities. • Receives inbound services calls and provide accurate complete information in response to provider inquiries, complaints and problems within a timely fashion. • Contact 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. • Act as liaison with providers, members and outside community resources. • Handle PCP/PCD changes for members. • Verification of PCP/PCD and member eligibility with Providers. • Maintain call documentation in databases with relevant information regarding special outreach projects in accordance with departmental focus and objectives. • Assist provider offices with issues associated to credentialing, recredentialing, claims and provider data maintenance by providing guidance on how to proceed with the process.
Job Requirements
- 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
- Prefers knowledge of Horizon products and services
- Requires knowledge of 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.
Benefits
- Comprehensive health benefits (Medical/Dental/Vision)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
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