The Network Development Coordinator’s primary focus is to support the VP of Network Development in securing participating provider agreements with new payers, obtaining gap-exception authorizations with out-of-network payers, and auditing insurance verifications completed by Insurance Verification Representatives.
II. PRIMARY DUTIES AND RESPONSIBILITIES
1. Reviews out-of-network and rejected/denied Insurance Verifications for accuracy and authorization/contracting opportunities. Generates daily and monthly results report.
2. Profiles health plans nationwide to identify Single-Case Agreement or Gap Exception Authorization and contracting opportunities.
3. Generates system reports to aid in prioritizing leads and health plan contracting efforts.
4. Prepares letters of interest and other health plan marketing materials.
5. Aids in preparing health plan agreements for executive review, which includes but is not limited to completing Contract Worksheets and Reimbursement Analysis documents.
6. Identifies and communicates patient leads from newly contracted health plans.
7. Prepares and maintains up-to-date Payer Requirement and Reimbursement Rate documents by reviewing contract terms, provider manuals and health plan correspondence.
8. Responsible for ensuring that Liberator Medical Supply is listed and listed accurately in all applicable printed and online health plan provider directories.
9. Aids in resolving health plan questions generated from teammates in IV, Sales and Operations.
10. Responsible for health plan implementation, account management and account development tasks, as assigned.
11. Responsible for the maintenance of certain payer, product, and pricing tables in the Fastrack system.
12. Completes department employee training on a routing basis as needed
13. Responsible for tracking and reporting daily productivity.
14. Performs other duties and tasks as assigned
II. PRIMARY DUTIES AND RESPONSIBILITIES
1. Reviews out-of-network and rejected/denied Insurance Verifications for accuracy and authorization/contracting opportunities. Generates daily and monthly results report.
2. Profiles health plans nationwide to identify Single-Case Agreement or Gap Exception Authorization and contracting opportunities.
3. Generates system reports to aid in prioritizing leads and health plan contracting efforts.
4. Prepares letters of interest and other health plan marketing materials.
5. Aids in preparing health plan agreements for executive review, which includes but is not limited to completing Contract Worksheets and Reimbursement Analysis documents.
6. Identifies and communicates patient leads from newly contracted health plans.
7. Prepares and maintains up-to-date Payer Requirement and Reimbursement Rate documents by reviewing contract terms, provider manuals and health plan correspondence.
8. Responsible for ensuring that Liberator Medical Supply is listed and listed accurately in all applicable printed and online health plan provider directories.
9. Aids in resolving health plan questions generated from teammates in IV, Sales and Operations.
10. Responsible for health plan implementation, account management and account development tasks, as assigned.
11. Responsible for the maintenance of certain payer, product, and pricing tables in the Fastrack system.
12. Completes department employee training on a routing basis as needed
13. Responsible for tracking and reporting daily productivity.
14. Performs other duties and tasks as assigned