Top 309 Claims Jobs in Martinsburg, Wv

Dental Field Provider Relations Representative - West Virginia
SKYGEN USA —West Virginia
- $62,676 - $94,014 a year
- Full-time
- Dental office
- Microsoft Excel
- Mid-level
7d
Psychologist
Matrix Providers —West Virginia
- $84 an hour
- Mid-level
Quick Apply
7d
EHS (Environmental, Health, Safety) Manager
NewCold —Hagerstown, MD
- $75,000 - $85,000 a year
- Management
- Senior level
7d
GENERAL LIABILITY CLAIMS ADJUSTER
The Carlisle Group —Hagerstown, MD
- $85,000 - $130,000 a year
- Computer literacy
- Master's degree
- Analysis skills
Quick Apply
8d
Sales Manager
Ashburn Roofing —Winchester, VA
- Full-time
- Mid-level
- Recruiting
- In-person
Quick Apply
1d
Warranty Service Carpenter
Fine Line Trim LLC —Martinsburg, WV
- $41,600 - $62,400 a year
- Full-time
- Carpentry
- Construction site
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
13d
Director of Rehabilitation
Martinsburg Healthcare Center —Martinsburg, WV
- Full-time
- Mid-level
- Rehabilitation center
- Physical Therapy License
- Continuing education credits
- Paid time off
Quick Apply
Licensed Mental Health Therapist - Remote (LICSW, LPC)
Talkspace —West Virginia
- $70 an hour
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Continuing education credits
15h
Safety Manager
Great Southern Wood Preserving —Hagerstown, MD
- Clean driving record
- Mid-level
- Driver's License
- Profit sharing
- Paid holidays
6d
Service Manager
Virginia Maryland Tractor —Purcellville, VA
- Extended hours
- Background check
- Sales
- Dealership
- Health savings account
- Health insurance
Quick Apply
Personal Lines Account Manager
Blue Ridge Risk Partners —Hagerstown, MD
- $58,000 - $70,000 a year
- Full-time
- Mid-level
- Office
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Human Resources/ Benefits Manager
Express Employment Professionals —Winchester, VA
- $30 - $35 an hour
- Part-time
- OSHA
- 5 years
- HIPAA
- Dental insurance
Quick Apply
17h
CDL A Lease Purchase Truck Driver - OTR
MN89 INC —West Virginia
- $2,500 - $3,500 a week
- Heavy lifting
- CDL A
- Mid-level
- Fuel card
Quick Apply
Central Supply Coordinator
Martinsburg Healthcare Center —Martinsburg, WV
- Full-time
- Skilled nursing facility
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Benefits & Payroll Specialist
DCM Inc —Hagerstown, MD
- From $80,000 a year
- Full-time
- Mid-level
- Microsoft Office
- 3 years
- AD&D insurance
- Disability insurance
Quick Apply
Office & HR Manager
Martinsburg-Berkeley County Parks & Recreation —Martinsburg, WV
- Weekends as needed
- Background check
- Microsoft Excel
- Microsoft Outlook
Quick Apply
4d
Call Center Representative
Battery Mart of Winchester, Inc. —Winchester, VA
- $18 - $20 an hour
- Full-time
- Computer literacy
- High school diploma or GED
- Computer skills
- Paid training
- Health insurance
Quick Apply
14d
Local Non-CDL Driver- FT- 28.28 per hour
Ward Trucking LLC —Winchester, VA
- $28.28 an hour
- Full-time
- Clean driving record
- Customer service
- Local
Administrative Support Specialist
Kent Cartridge —Kearneysville, WV
- $18 - $21 an hour
- Part-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Employee assistance program
- Employee discount
Quick Apply
Chaplain
US Veterans Health Administration —Martinsburg, WV
- $85,447 - $111,087 a year
- Online Application
- Background check
- Writing skills
- Pass drug screening
8d

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claims jobs near martinsburg, wv

Dental Field Provider Relations Representative - West Virginia

SKYGEN USA -
West Virginia

Apply Now

Job Details

Full-time
$62,676 - $94,014 a year
7 days ago

Qualifications

Customer relationship building
Client relationship development
Medicaid health insurance
Medicaid
Productivity software

Full Job Description

What are important things that YOU need to know about this role based in West Virginia?

Seeking a self-driven rock star that has Medicaid experience - located in West Virginia.
Given the nature of the work, the person will be in field 3 to 4 days per week and working from a home office the remainder of the time.

What will YOU be doing for us? Provide support to specific market by researching, working with internal staff, and providing resolution to high value providers. Utilize knowledge of market and potential providers to resolve specific network deficiency issues through proper recruiting practices.

What will YOU be working on?

Build and maintain appropriate relationships with provider network by ensuring regular communications and timely problem resolution.
Conduct annual dental office visits.
Conduct site audit data collection.
Conduct mobile unit audits.
Develop training and presentation materials relative to market needs.
Host regular training sessions for new and existing providers.
Promote use of Dental Hub (provider web portal).
Act as resource to both client and providers in the network to resolve complex claim and authorization issues.
Utilize the provider-related modules in the Enterprise System to research claim and reimbursement questions.
Accurately and timely assess issues presented from provider offices that can be handled by other internal resources and provide offices with appropriate contacts to obtain resolution.
Utilizing follow up requests from internal staff or client direction, recognize potential market deficiencies and network to obtain referrals for potential providers.
Recruit and work with potential providers to discuss potential contract terms or negotiations needed to resolve network deficiencies.
Through establishment of positive relationships with providers in the geography, arrange care with out of network providers for single case agreements including recommending a provider, negotiating the fee and securing the single case agreement contract.
Using automated systems, maintain updated data on client owned provider networks by verifying accuracy and handling any exceptions or issues.
Coordinate and conduct provider advisory board meetings.
Identify appropriate community relationships and develop partnerships designed at increasing visibility of client programs.
Support Credentialing and Network Development strategies.

Additional Responsibilities:

Provide feedback to Provider Relations team regarding potential topics for provider training references and materials.
Assist department with administrative tasks and additional duties as needed.
Work with Clients and Providers to analyze market, system and operational trends and develop and propose solutions and interventions to improve the client/provider/member experience and/or reduce costs.
Document provider communication within organization applications.
Work with Clients and Providers to analyze market, system and operational trends and develop and propose solutions and interventions to improve the client/provider/member experience and/or reduce costs.

What qualifications do YOU need to have to be GOOD candidate?

Bachelor’s degree in a related field or equivalent years of experience.
3-5 years of job related experience (provider relations, account management, or managed care).
Excellent communication written and verbal communication skills.
Ability to think strategically regarding the direction of the market, provider needs and the client relationship.
Ability to build and maintain collaborative working relationships with diverse individuals.
Ability to exercise influence without formal authority.
Ability to ensure timely problem resolution despite multiple priorities.
Intermediate knowledge of Microsoft Office products including Word, Excel, and email.

What qualifications do YOU need to have to be GREAT candidate?

Bachelor’s Degree in Business or a related field.
Experience in a managed care environment.
Experience working in the field or with field issues.
Experience with government dental programs.

Pay: $62,676.00 - $94,014.00 per year

Work Location: On the road

Apply Now

Refine Your Search

claims jobs in martinsburg, wv

Dental Field Provider Relations Representative - West Virginia

Psychologist

EHS (Environmental, Health, Safety) Manager

GENERAL LIABILITY CLAIMS ADJUSTER

Sales Manager

Warranty Service Carpenter

Director of Rehabilitation

Licensed Mental Health Therapist - Remote (LICSW, LPC)

Safety Manager

Service Manager

Personal Lines Account Manager

Human Resources/ Benefits Manager

CDL A Lease Purchase Truck Driver - OTR

Central Supply Coordinator

Benefits & Payroll Specialist

Office & HR Manager

Call Center Representative

Local Non-CDL Driver- FT- 28.28 per hour

Administrative Support Specialist

Chaplain

I want to receive the latest job alert for claims in martinsburg, wv

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