- Review, research, and respond to Provider Network quality requests submitted through the Provider Information Network System (PINS) ticketing system. Collaborates with program management and medical staff as necessary.
- Develop training materials and presentations for distribution to Provider Network facilities and/or providers.
- Provide guidance and education to Provider Network staff on component and/or client specific protocol.
- Track provider data issues, progress and status for reporting to management.
- Establish an effective working relationship with Provider Network administrators and their staff; respond in a timely fashion to their identified concerns.
- Prepare materials for the Provider Network operations monthly health network forum.
- Assist with the creation of written communications to the network providers, including the weekly email communications regarding new or changing contract requirements.
- Responsible for the distribution and tracking of the Provider Network facility surveys.
- Ensure ongoing Provider Network data accuracy through regular reconciliation of the Provider Information Network System (PINS).
- Responsible for the distribution of exam results received from our network facilities.
- High School diploma with 1-year relevant experience (provider relations, network management, customer service, quality assurance and/or negotiations) required.
- Proven conflict resolution experience required.
- Proficiency with computer and common office equipment, as well as with MS Office products required.
- Must have excellent oral and written communication skills; strong analytical/problem-solving skills; and excellent attention to detail
- Associate degree with 2 years of relevant experience (provider relations, network management, customer service, quality assurance and/or negotiations) preferred.
- Medical, dental, or healthcare network and/or insurance experience preferred.
- Work is normally performed in a typical interior/office work environment.
- Work involves sitting for prolonged periods of time.
- May require bending, stooping and lifting up to 15 lbs.
Acuity International is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, national origin, age, protected veteran status, or disability status.