Job Information
Elevance Health Network Education Rep Sr in INDIANAPOLIS, Indiana
Location: Indianapolis, IN
Hours: Standard M - F
Travel: Hybrid (1-2 days in office per week) – Travels to worksite and other locations as necessary.
Position Overview:
LTSS Claims Educators who are in Indiana and facilitate the exchange of information between the grievances, claims processing, and provider relations systems. This position works closely with the Network Education Rep to develop training content specific to LTSS provider claims, to be incorporated into LTSS provider onboarding and continuing education. As well as tracking and trending LTSS claims data, providing technical assistance and ad-hoc training to LTSS providers both virtually and in-person.
How You Will Make an Impact:
Educating contracted and noncontracted providers (professional and institutional) regarding appropriate claims submission requirements, coding updates, electronic claims transactions, and electronic fund transfer
Educating contracted and non-contracted providers on available Contractor resources such as provider manuals, website, fee schedules, etc
Interfacing with the Contractor’s call center to compile, analyze, and disseminate information from provider calls
Identifying trends and guiding the development and implementation of strategies to improve provider satisfaction; and frequently communicating with providers, including conducting on-site visits, to assure the effective exchange of information and gain feedback regarding the extent to which providers are informed about appropriate claims submission practices
Provides/coordinates provider training for claims and billing procedures and contract compliance
Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations
Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies
Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies
Required Qualifications:
- Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background
Preferred Qualifications:
Prior experience as an LTSS or HCBS provider or in a provider office is preferred
Intermediate Excel experience strongly preferred
SQL experience preferred
Experience training or mentoring preferred