Top 162 Relations specialist Jobs in Connecticut

Provider Reimbursement Specialist - Fee Schedules
Fidelis Care —Connecticut
- $56,200 - $101,000 a year
- Full-time
- Remote
- Research
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Patient Relations Specialist
Yale New Haven Health —New Haven, CT
- Full-time
- Nursing
- Hospital
- Computer literacy
Employee Relations Specialist
Middlesex Health —Middletown, CT
- Full-time
- Research
- Mid-level
- 3 years
- Tuition reimbursement
Guest Relations Specialist
Tauck —Wilton, CT
- Research
- Mid-level
- Communication skills
Transition Specialist
Yale University —Hamden, CT
- $35.64 an hour
- Full-time
- Background check
- Current TB test
- Psychiatry
9d
Senior PR Specialist (6-month contract)
KAYAK —Norwalk, CT
- $90,000 - $110,000 a year
- Full-time
- Hybrid work
- 5 years
- Research
- Office
- Employee discount
- Food provided
Quick Apply
Provider Network & Wraparound Funding Specialist
Advanced Behavioral Health, Inc —Middletown, CT
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Quick Apply
PROCESSING SPECIALIST I
Palco —Hartford, CT
- Full-time
- Remote
- HIPAA
- Research
- High school diploma or GED
- Paid training
- AD&D insurance
5d
Sr. Specialist, Corporate Communications & Events
Philip Morris International U.S. —Stamford, CT
- $97,000 - $121,000 a year
- Full-time
- Writing skills
- English
- Office
- Commuter assistance
- Health insurance
Employee Relations Specialist
Akumin —Hartford, CT
- $68,000 - $80,000 a year
- Full-time
- Mid-level
- Bachelor's degree
- Experience equivalent to degree accepted
- Health savings account
- Paid holidays
Quick Apply
6d
Provider Network & Wraparound Funding Specialist
Advanced Behavioral Health (ABH®) —Middletown, CT
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Alumni Relations Coordinator (Hybrid)
THE UNIVERSITY OF CONNECTICUT FOUNDATION INC —Storrs, CT
- $60,000 - $65,000 a year
- Full-time
- Hybrid work
- Microsoft Outlook
- Research
- Mid-level
- Health savings account
- Paid holidays
Clinical Quality & Performance Improvement RN - On Site
Trinity Health Of New England —Hartford, CT
- Full-time
- Nursing
- RN License
- Master's degree
- Benefits from day one
Accounts Payable Specialist
Kingswood Oxford School —West Hartford, CT
- $38,000 - $42,000 a year
- Full-time
- Background check
- Google Workspace
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
Therapeutic Educational and Recreational Specialist
Oak Hill —Waterbury, CT
- Full-time
- Mid-level
- Master's degree
- Organizational skills
- Paid training
- Health savings account
Quick Apply
Revenue Cycle and Accounts Receivable Specialist
The Plastic & Reconstructive Surgery Group —Greenwich, CT
- From $60,000 a year
- Full-time
- Private practice
- Surgery
- English
- Health insurance
- 401(k)
Quick Apply
10d
Proposal Writer II
CW Resources, Inc. —New Britain, CT
- $75,000 - $78,500 a year
- Extended hours
- Mid-level
- Office
- Master's degree
- Wellness program
- Paid holidays
Quick Apply
Military Service - Air Force Reserve, Fire Protection
Military Service - Air Force Reserve —Hartford, CT
- From $40,000 a year
- Part-time
- High school diploma or GED
- Driver's License
- Driving
- Health insurance
- Tuition reimbursement
Marketing Communications Specialist
Freemont Yardley Search —Hamden, CT
- $105,000 a year
- Oracle
- Marketing
- 5 years
Senior Associate Information Reporting and Withholding NYFS
KPMG —Stamford, CT
- Full-time
- Research
- Mid-level
- Bachelor's degree
- Disability insurance
- Health insurance
5d

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Provider Reimbursement Specialist - Fee Schedules

Fidelis Care -
Connecticut

Apply Now

Job Details

Full-time
$56,200 - $101,000 a year

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Research
Customer complaint resolution

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Applicants for this job have the flexibility to work remote from home and preferably reside in New York or within the tri-state area.

Position Purpose: Maintains relationships with physicians, hospitals, ancillary providers and Health Net's internal Provider Network Management Dept. Acts as first line contact for providers/hospitals on claims projects and other non-routine claim issues. Oversees, in conjunction with the Adjustment and New Day Unit Supervisors, resolution of project issues and is responsible to communicate final resolution to the provider/hospital or other business units and/or managers, as needed and/or as required. Assists with policy and procedure interpretation. Researches, analyzes and resolves complex problems with claims development and finalization.

Assists with complex claim issues and acts as the first line contact for providers on large projects and non-routine claim issues.
Manages projects in conjunction with assigned adjusters and/or regional units for research, analysis and resolution.
Responds directly to the providers with final resolution of the issues, up to and including: root cause documentation/feedback, necessary corrective action plans and/or process improvement initiatives.
Conducts routine periodic site visits to providers/physicians/facilities.
Participates with Network Management in Joint Operating Committee (JOC’s).
Coordinates with Provider Network and Provider Data Management for contract data corrections.
Identifies and reports to Provider Network Management contracting opportunities with problematic provider contracts based on root cause analysis.
Interprets Health Net’s Policy and Procedures as it relates to claim issues, providing interpretation and clarification on contracts and benefits.
Coordinates with Provider Network Management (PNM) if unable to resolve with provider and internal departments.
Participates in process improvement activities working directly with the process improvement team to report root causes and facilitates corrective actions as needed.
Prepares monthly reports to management to document issues, action plans, and resolutions of quality initiatives and provider relation improvement initiatives.
Researches and responds to Shared Risk Discrepancies from Participating Provider Groups.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience: Bachelor’s degree in Health Services, Health Care/Hospital Administration, a related field or any combination of education and/or work experience providing equivalent background required. Minimum of two years experience in medical claims review and/or claims appeal required.

Preferred Qualifications: Candidates with strong claims analysis experience. Experience with independent dispute resolution (IDR) and provider fee schedules.

Pay Range: $56,200.00 - $101,000.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

relations specialist jobs in connecticut

Provider Reimbursement Specialist - Fee Schedules

Patient Relations Specialist

Employee Relations Specialist

Guest Relations Specialist

Transition Specialist

Senior PR Specialist (6-month contract)

Provider Network & Wraparound Funding Specialist

PROCESSING SPECIALIST I

Sr. Specialist, Corporate Communications & Events

Employee Relations Specialist

Provider Network & Wraparound Funding Specialist

Alumni Relations Coordinator (Hybrid)

Clinical Quality & Performance Improvement RN - On Site

Accounts Payable Specialist

Therapeutic Educational and Recreational Specialist

Revenue Cycle and Accounts Receivable Specialist

Proposal Writer II

Military Service - Air Force Reserve, Fire Protection

Marketing Communications Specialist

Senior Associate Information Reporting and Withholding NYFS

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