SCA Provider Relationship Research Specialist
Elevance Health

Job Info

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Location: Virtual; Within 50 miles of an Elevance Health Pulse Point location

Shift: Monday - Friday; 8:00am - 5:00pm

The SCA Provider Relationship Research Specialist is responsible for improving the providers relationship with Medicare. Provides quality, accessible and comprehensive service to the Medicare provider community.

How you will make an impact:

• Provides assistance regarding education and non-routine claim issues.
• Coordinates communications process on such issues as administrative and medical policy.
• Develops, maintains, and enhances relations with providers to foster cooperative business relationships.
• Coordinates prompt claims resolution through direct contact with providers and claims department.
• Provides assistance with policy interpretation.
• Researches, analyzes, and recommends resolution for provider disputes as well as issues with billing and other practices.
• Tracks customer service patterns/trends and identifies provider training when appropriate.
• Assists with incoming calls and responds to complex correspondence inquiries.

Minimum Requirements:

• Requires a High School diploma or equivalent and a minimum 3 years customer service experience as well as experience with Medicare DME, Part A and or Part B policies; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, capabilities, and experiences:

• Provider recruitment
• Provider Training and Orientation(Billing, Claims, Contract Compliance, etc)
• EDI experience
• Provider Compliance
• Resolve Provider/Participant issues
• Provider Credentialing
• Claims Resolution

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

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