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Medical Networks Specialist

Berkshire Hathaway Homestate Companies Omaha, NE
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Job Description

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NOTE: BHHC does not conduct interviews via social media (e.g. Google hangout, LinkedIn, etc.). Please be aware that any such contact is fraudulent and we advise that you not provide any personal information.

WHO WE ARE

As a member of the Berkshire Hathaway group of insurance companies, we offer outstanding opportunities for professionals interested in working with a successful company. We offer unparalleled financial strength, stability and “large company” benefits, in addition to an exciting, friendly, “small company” atmosphere.

POSITION DESCRIPTION

Berkshire Hathaway Homestate Companies has an opening in our Omaha, NE Office location for Medical Networks Specialist. We are looking for someone who is able to foster effective working relationships with providers and has credentialing experience. The Medical Provider Networks/Panels Specialist is responsible for maintaining accurate medical provider data within the Company’s existing provider networks and panels. The position is a liaison to existing and new provider networks and panels, and required to facilitate the assessment and enrollment of new providers.

RESPONSIBILITIES

  • Assist in the enrollment and maintenance of medical provider networks and panels for the treatment of injured workers.
  • Ensure provider documentation is complete, current and accurate through provider source verification, as well as ensure the accuracy of provider data entered into the Excel database.
  • Assist in monitoring provider performance and provide feedback to key stakeholders and/or providers as required.
  • Work with network providers through resolution of inquiries and education as to new protocols, policies and procedures.
  • Foster a close working relationship with other Company staff, including Utilization Review, Medical Bill Review, Nursing Services, Special Investigations, Adjusting Staff, Legal, Lien Resolution the Call Center and Client Services.
  • Provide support for claims staff and injured workers by directing them into the network in a timely manner.
  • Assist with operational functions to ensure compliance with state statutes and regulations, including data tracking, preparation of packets of information for regulatory review and compilation of information in response to audits.
  • Ensure work is performed in accordance with Company standards, training and supervisory direction to ensure compliance with corporate and regulatory standards.

QUALIFICATIONS

EDUCATION/EXPERIENCE: Associate’s degree from an accredited college or technical school; or at least three years of relevant experience in provider services/relations within a health plan or medical group; familiar with credentialing; or an equivalent combination of education and experience.
COMPUTER SKILLS: To perform this job successfully, an individual must have knowledge of Microsoft Excel spreadsheet software and Microsoft word processing software; Able to quickly master proprietary and vended software applications.
TECHNICAL SKILLS: Solid knowledge base in the delivery of health care. Exposure to either physician and/or hospital credentialing is preferred.
LANGUAGE ABILITY: Able to read and interpret complex documents including statutes, regulations, legal opinions, legal letters, medical records, medical bills, medical resource materials, claim notes and claim data fields; Able to write clear, effective correspondence on medical points; Able to effectively present information and respond to questions with managers, staff, medical providers and others.
MATH ABILITY: Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; Able to compute rate, ratio, and percent.

REASONING ABILITY: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form; Able to deal with problems involving several concrete variables in standardized situations.

COMPREHENSIVE BENEFITS PACKAGE:

  • Health and wellness – low premiums for medical, dental and vision coverage, FSA and EAP benefits
  • Company paid Life, Disability and ADD benefits
  • Employee Retirement Savings Plan with employer match up to 5 percent of compensation
  • Generous Paid Time Off and Holidays
  • Education Assistance Reimbursement
  • Recognition and Rewards Programs
  • Company Store
  • Discounts across Berkshire Hathaway Inc. companies such as GEICO, See’s Candies, etc.

ABOUT US:

The Berkshire Hathaway Homestate Companies (BHHC) is a group of six insurance companies that are part of the Berkshire Hathaway Insurance Group. Our Workers Compensation Division provides premier workers compensation insurance coverage to employers across the country, with offices in San Francisco, San Diego, Sacramento, Pasadena, Omaha, Philadelphia, St. Louis, Atlanta, and Dallas.

As a member of the Berkshire Hathaway Insurance Group, BHHC has earned an enviable record of success in the insurance industry that is supported by an A++ A.M. Best rating for the last 10 consecutive years. Our corporate size enables our organization to react swiftly and effectively to opportunities in the insurance marketplace. At the same time, our financial strength provides our agents and insureds security and makes us one of the best brands in the marketplace.

We value each individual and recognize that attracting and retaining high quality talent is essential to the success of our company. Our structure minimizes bureaucracy and creates an environment that encourages our employees to see the direct effects of their hard work throughout the company. Each division provides hands on training and maintains a small company feel, creating an atmosphere in which 'team players' thrive.

Within the last six years BHHC Workers Compensation has seen significant growth, and we’re continuing to grow as we build one of the largest Workers Compensation companies in the country – join us!

This organization participates in E-Verify. For more information on E-Verify, please contact DHS: 888.897.7781 www.dhs.gov/E-Verify.

We will consider for employment qualified applicants with criminal histories as required by local ordinance. Additionally, no applicant will be denied employment solely on the grounds of conviction of a criminal offense except to the extent necessary to obtain a necessary license or to comply with The Violent Crime Control and Law Enforcement Act of l994, which prohibits the employment by an insurance company of persons convicted of certain crimes, unless a waiver is obtained.

Job Details

Date Posted August 22, 2018
Date Closes September 21, 2018
Located In Omaha, NE
Department Medical Management
Function Administrative
Job Type Full-time Employee
Compensation Hourly Wage, Based on Experience
Experience Level Entry Level (0-2 yrs. experience)
Shift
Daytime
Monday - Friday 8 am - 5 pm
Positions Available 1
SOC Category 43-6013.00 Medical Secretaries
Zipcode 68102

This job offers the following benefits

  • 401(k) Retirement Savings Plan
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Dental
  • Medical
  • Vision
  • Cafeteria / Food
  • Casual Dress
  • Discounts on Employer Merchandise & Services
  • Employee Referral Program
  • Flexible Hours
  • Holiday Party
  • On-the-Job Training
  • Paid Holidays
  • Tuition Reimbursement
  • Wellness Program
At a Glance
Enjoy these benefits
  • 401(k) Retirement Savings Plan
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Dental
  • Medical
  • And More ...
Location