Anthem, Inc. Network Relations Consultant - Single Case Agreement (SCA) in Iselin, New Jersey
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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 at one of America's leading health care companies and a Fortune Top 50 Company.
Network Relations Consultant
Work Location – Iselin, New Jersey
Responsible for coordinating non-negotiated contracts for new and existing providers as needed and facilitating the execution of negotiated Single Case Agreements (SCAs) with providers, verifying provider credentials as applicable.
Serves as a knowledge and resource expert regarding provider issues related to SCAs and resolves complex provider issues for prompt resolution. Researches, analyzes and recommends resolution for contract disputes, non-routine claim issues, billing questions and other practices.
Identifies network access and deficiencies and communicates recruitment opportunities.
Responsible for providing quality, accessible and comprehensive service to the company's provider community.
Responsible for providing quality, accessible and comprehensive service to the company's internal community.
Coordinates prompt claims resolution through direct contact with providers, claims, pricing and medical management department. Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery. Researches issues that may impact future provider negotiations or jeopardize network retention.
Requires a Bachelor's degree; 3 years of customer service experience including 2 years’ experience as a Network Management Rep; or any combination of education and experience, which would provide an equivalent background.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.