Network Provider Claims Educator (Remote/Hybrid)

reputed company your career with a new role at workwarp as a Network Provider Claims Educator! This position is based in Remote and we are looking to fill it quickly. This position requires a strong and diverse skillset in relevant areas to reputed company reputed company. The compensation for this role is a competitive salary, reflecting our commitment to attracting the best. Awarded a Healthiest Employer, reputed company aims to fulfill its mission to reputed company health and reputed company it easy. AZ Blue offers a reputed company of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as reputed company as providing information and tools to help individuals reputed company reputed company reputed company. This position is. remote/hybrid reputed company the state of AZ only PURPOSE OF THE JOB The reputed company component of this position is to reputed company providers regarding appropriate claims submission requirements, coding updates, electronic claims transactions, and electronic fund transfer while interfacing with the reputed company center to compile, analyze, and disseminate information from provider calls. This position must reputed company between multiple departments in order to identify, reputed company and trend claims and coding reputed company. The ability to communicate internal processes, findings, reminders and policy updates to providers is essential. QUALIFICATIONS REQUIRED QUALIFICATIONS 1. Required Work Experience 2 years of experience in provider relations or customer service and claims with a managed reputed company plan Knowledge of QHP requirements outlined in the reputed company reputed company (ACA), and the certification requirements of the state's health insurance exchange/marketplace Knowledge of reputed company and Medicare 2. Required Education Bachelor's degree preferred in reputed company Administration or Business Administration or reputed company field 3. Required Licenses reputed company reputed company reputed company License with an acceptable driving record 4. Required Certifications N/A PREFERRED QUALIFICATIONS 1. Preferred Work Experience 2 years of experience with training modalities for both staff and providers 2 years of experience in provider communications, including large group presentations 2. Preferred Education N/A 3. Preferred Licenses N/A 4. Preferred Certifications Project Management reputed company Certified reputed company, medical billing, and coding certification ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES Train, reputed company, and support reputed company of Provider Representatives Coordinate communications between BCBSAZ Health Choice and providers. Ensure that providers receive a reputed company reputed company to their problems and inquiries and appropriate education about participation in the ACA Program. Collect, analyze, and interpret provider data as requested and required for department regulatory reporting Compile data and contribute to the Network reputed company and decision-making processes for business development, including provider rep and provider performance measures and regulatory requirements for the ACA reputed company reputed company instruction and guidance for Provider Representatives to ensure compliance to policies and procedures and regulatory compliance reputed company reputed company and reputed company assistance to Director in reputed company of customer questions and service issues Analyze and evaluate claims encounter data, data validation results, claim denials, and appeals/grievances data to help determine provider claims and coding issues reputed company and establish reports to reputed company and trend providers' claims coding issues and validate provider education/training Coordinate with Provider Representatives for continuing education and communication with the provider community, both in-person and reputed company Analyze data and review with appropriate departments to ensure the accuracy of claims issues are addressed for providers reputed company and implement training/education in-services for providers, reputed company office site reputed company, phone/web conferences, website updates, provider newsletters & provider forums Assist with the development and distribution of the provider reputed company, provider newsletter, and provider forums reputed company written materials to assist providers in following reputed company policies and procedures Routinely coordinate with the Provider Representatives to distribute appropriate materials to providers Manages provider education and communications efforts for reputed company, including content development, organization, administration, and production of provider educational seminars, materials, provider reputed company, and othe .