Anthem Network Management Rep - Mendota Heights, MN - PS12985 in Mendota Heights, Minnesota

Network Management Rep - Mendota Heights, MN - PS12985

Location: Mendota Heights, Minnesota, United States

Field: Provider Network Management

Requisition #: PS12985

Post Date: Oct 02, 2018

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care .

This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

Network Management Representative I

Level I

Provides comprehensive services to the provider community, supports contracting activities and as needed, assists with

cost of care initiatives. Primary duties include, but are not limited to:

  • Receives inbound inquiries from providers which may include requests for an application and agreement, questions

about the provider contract, demographic changes, etc.

  • Develops, maintains, and enhances relations with providers to foster cooperative business relationships.

  • Maintains clear lines of communication.

  • Maintains provider log for new requests.

  • Submits and routes complete applications for loading.

  • Gathers credentialing information and processes through credentialing.

  • Validates participation criteria for non-credentialed providers.

  • Assists providers with provider demographic changes and routes as appropriate.

  • Manages department Shared Email/voicemail as appropriate.

  • Distributes welcome letter/reference materials to providers as appropriate.

  • Responds to urgent/escalated requests, as necessary.

  • Researches, analyzes and recommends resolution for provider disputes and identifies training needs as appropriate.

  • Assists with audits as needed in a timely manner.

  • Provides support for special projects and prioritizes workload as needed.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.

Level I

  • Requires a H.S. diploma.

  • Associates Degree preferred

  • 1-3 years of customer service experience; or any combination of education and experience, which would provide an

equivalent background.

  • MS Word and MS Excel required.

  • MS PowerPoint preferred.

  • Process improvement and documentation experience preferred

  • Fast paced and dynamic work experience preferred

  • Self-driven and team project experience preferred