Network Analyst (Provider Relations & Claims experience must reside in MI) in Wixom, MI at Beacon Health Options

Date Posted: 9/23/2019

Job Snapshot

Job Description

About the Position: 

We are currently seeking a dynamic full-time Network Analyst to join our team at our office in Wixom, MI. The Network Analyst will be responsible for the various levels of activities supporting recruitment, credentialing, and contracting process for potential and current Beacon providers.

 Position Responsibilities:

  • Answers practitioners’/facility recruitment questions regarding Beacon policies and procedures, contracting requirements, and claims issues. Participate in responding to provider inquiries and problems.
  • Provides follow up with practitioners and facilities for the return of completed credentialing and re-credentialing applications and contract documents.  Verifies claims and application information with providers to update database.  Process letters of resignation and may initiate disenrollment’s.  Responds to provider requests for credentialing information.
  • Provides assistance in compilation and mailing of provider recruitment mailings, general information and educational materials to network practitioners as required.  Assists Provider Relations Managers with research to identify new providers for recruitment into the Beacon provider network.  Initiates written requests to providers for credentialing information.  Responsible for the coordination and implementation of activities necessary for the identification, review and selection of mental health and substance abuse treatment providers in support of Beacon Network Development.
  • Performs research and problem resolution on issues related to provider complaints, claims reported to have been processed incorrectly, coordinating credentialing paperwork, provider communications or verification of information as requested.  Assists Provider Relations Managers with report requests for network management purposes.  Reviews/analyzes provider information through database queries.  Review denial reports, weekly approval disenrollment grids and research information regarding this provider and the area(s) served.  Meet with Provider Relations Managers and Director, Provider Relations staff and Service Center staff to present information discuss plans of action to avoid disenrollment of key providers. 

 Position Requirements:

  • Education:   This position requires a Bachelors’ Degree in a Human Services field, equivalent Bachelor’s Degree or equivalent work experience in a behavioral health or managed care environment in lieu of a Bachelor’s degree.
  • Years and Type of Relevant Work Experience: At least three years of experience in customer service, claims, auditing or provider relations in the behavioral health or managed care setting is required. Knowledge of and experience in provider benefits administration/health care setting. Knowledge of and experience with providers and provider network. 

 Knowledge, Skills & Abilities:

  • Excellent verbal and written communication skills
  • Professional bearing and be able to speak comfortably with physicians, senior facility administrator and mental health professionals
  • Have strong problem-solving skills.
  • All applicants will be required to demonstrate their written communication skills by participating in a written test.

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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