Network Management Specialist
• Served as Plan liaison to assigned counties of contracted providers in order to assure effective communications, prompt problem identification and solution, and maintenance of consistently positive working relationships.• Collected and reported information on the assigned counties of contracted providers in order to assure that the Plan provider database is current and correct.• Demonstrated thorough knowledge of Network management department polices and procedures, and provider contractual agreements.• Interfaced regularly with appropriate internal departments of BCBSNC to communicate provider concerns.• Handled correspondences from network providers and submitted database maintenance form request for demographic changes and other provider change request.• Talked with providers by phone, to resolve escalated problems, issues and concerns, including provider setup, credentialing, reimbursement, billing, and explanation of benefits and payments.