Casualty, Support Specialist

About The Role Provide the support necessary to grow, build and maintain the relationship between Casualty customers and network providers. Provide education and issue resolution to MagnaCare network providers and customers, for the Workers’ Compensation and No Fault lines of business. Work closely with both providers and customers, when there is a dispute raised by a network provider or customer. Maintain comprehensive knowledge of provider and company specific policies and procedures. Partner with Provider Contracting, Sales, Medical Management and Operations Department in identifying and resolving provider issues. The Support Specialist reports to the Manager of Casualty Support. The successful candidate will be afforded an opportunity to help further structure this team. This team is a critical component to the delivery of quality healthcare services. Primary Responsibilities Educate providers on current policies, trends and information affecting their participation within the MagnaCare networkAct as liaison for interpretation of No-Fault and Workers Comp contractsRespond to inquiries specifically related to the provider’s contract or claim issueResearch provider contract/claim issues received by the provider or the client, and perform claims analysisMaintain database for provider issues and creating detailed reports as neededLog credentialing applications and assist with the Casualty enrollment processNegotiate solutions and resolve conflicts in a manner that will insure client/provider satisfactionMaintain provider network by negotiating/retaining key providersSurface issues and work with interdepartmental representatives to establish plans for resolutionCoordinate efforts with members of the management team in developing short and long term plans that result in high performance provider servicesAssist in the development and update of provider panelsProvide back-up and support to other Casualty departments, including Care CoordinationAssist with Provider and/or Customer Implementations as needed Essential Qualifications Superior oral and written communication skillsStrong PC skills (excel is a must)Knowledge of the health insurance industry, products and servicesFamiliarity with claims and claims processingStrong follow up, negotiating and influencing skillsExcellent problem solving skillsCapable of managing multiple complex issuesAbility to maintain professional demeanor under pressureWork well independently and as a team playerMinimum of two years experienceBachelor degree or equivalent experience