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Job Details

Provider Panel Coordinator - Managed Care Claims

Location
Morristown, NJ, United States

Posted on
Jul 29, 2020

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Profile

u003cpu003eCu0026amp;F (Crum u0026amp; Forster) is a leading national property u0026amp; casualty insurance company with a large, diversified specialty platform. With deep roots going back to 1822, will soon be celebrating our 200u003csupu003ethu003c/supu003e anniversary and are proud of our history and excited about our future. Our most valuable asset is our people - 2000 employees, and growing, in locations throughout the United States - committed to delivering customized products with superior customer service.u003c/pu003enu003cpu003eWe care about each and every one of our employees and customers we work to serve and believe our deeply rooted philosophy of corporate giving, culture of high performance, innovation and integrity all exemplify this. From our parent company, Fairfax, to our Cu0026amp;F leadership, a philosophy of balance allows our employees to participate fully at work, in their communities, and have plenty of time to enjoy their lives outside of work.u003c/pu003enu003cpu003eFor more information about Crum u0026amp; Forster, please visit our website: u003ca href=u0022****target=u0022_blanku0022 rel=u0022noopeneru0022u003e****part of the Cu0026amp;F Commercial Lines Managed Care Claims team, you will be responsible for the quality, production, and maintenance of provider panels for selected Workersu0026rsquo; Compensation insureds.u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003ePrimary Location:u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; Morristown, NJu003cbr /u003eu003c/strongu003eu003cstrongu003eFunction:u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp;u0026nbsp; Provider Panel Coordinator u0026ndash; Managed Care Claimsu003c/strongu003eu003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eWhat you will do:u003c/strongu003eu003cstrongu003eu0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eu003cstrongu003eManaged Care Claims/Provider Panelsu003c/strongu003eu003c/pu003enu003culu003enu003cliu003ePrepare medical provider panels for insureds.u003c/liu003enu003cliu003eVerify all providers for specialty, address and acceptance of WC.u003c/liu003enu003cliu003eEnsure the created panels meet the individual state requirements in both language and content. Work with Account Management team to develop workflows and procedures.u003c/liu003enu003cliu003eWork to develop metrics/reporting and tracking of panel production, to ensure quality and consistency.u003c/liu003enu003cliu003eMaintain accurate records and house them per established department protocols.u003c/liu003enu003cliu003eAbility to conduct meetings to gather information and present business solutions to customers and stake holders.u003c/liu003enu003cliu003eEffectively manage turn around and response times, completing all required work within appropriate time frames.u003c/liu003enu003cliu003eCoordinate and maintain a system for tracking provider comments.u003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eManagement and Communicationu003c/strongu003eu003cstrongu003eu0026nbsp;u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eServe as liaison between insureds, vendors, and medical providers within our preferred networks, the account management team, and stakeholders.u003c/liu003enu003cliu003eTrack, measure, report, and evaluate vendor performance, identifying action plans to remedy or improve upon any workflows or quality of product.u003c/liu003enu003cliu003eMust be highly organized, possess the ability to multi-task, and keep accurate records.u003c/liu003enu003cliu003eMust possess excellent interpersonal skills, exceptional customer service skills along with solid verbal, and written communication skills.u003c/liu003enu003cliu003eRegular communication to leadership and other stakeholders on results and areas of focus and improvement.nu003cpu003eu003cstrongu003eu0026nbsp;u003c/strongu003eu003c/pu003enu003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eWhat YOU will bring to Cu0026amp;F:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eBacheloru0026rsquo;s degree and proficiency in medical terminology is required.u003c/liu003enu003cliu003eExperience with medical office roles, and knowledge of insurance is preferred and highly desired.u003c/liu003enu003cliu003eDemonstrated ability to multitask and problem solve.u003c/liu003enu003cliu003eMust be highly proficient with internet research skills.u003c/liu003enu003cliu003eMastery of Microsoft Office suite of products including but not limited to Excel is required.u003c/liu003enu003c/ulu003enu003cpu003eu003cstrongu003eWhat Cu0026amp;F will bring to YOU:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eCompetitive compensation package.u003c/liu003enu003cliu003eGenerous 401K employer match.u003c/liu003enu003cliu003eEmployee Stock Purchase plan with employer matching.u003c/liu003enu003cliu003eGenerous Paid Time Off plan.u003c/liu003enu003cliu003eExcellent benefits that go beyond health, dental u0026amp; vision. Our Wellness programs focus on your familyu0026rsquo;s complete wellness, including your physical and mental wellbeing.u003c/liu003enu003cliu003eA core Cu0026amp;F principle is that you manage your career. To support your development, we have a wealth of ways for you to keep learning, including tuition reimbursement, industry related certifications, and professional training available to you.u003c/liu003enu003cliu003eA dynamic, ambitious, fun, and exciting work environment.u003c/liu003enu003cliu003eA spirit of social responsibility, matching donation program, volunteer opportunities, and an employee driven corporate giving program.u003c/liu003enu003c/ulu003enu003cpu003eu003cbr /u003eAt Cu0026amp;F you will BELONG! We value inclusivity and diversity. We are committed to providing equal employment opportunity and welcome everyone regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. If you require a special accommodation, please let us know.u003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003e#LI-APu003c/pu003e,EqualOpportunityEmployerDescription:null,PayTransparencyPolicyStatement:null,MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:true,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:d49542d6-5e5d-4453-a2dd-8ebe3f5777fc,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2020-07-29T11:45:37.342Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null,Assessments:[],ApplicationId:null});

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