Provider Network Specialist

The Provider Network Management team is excited to announce an opening for a Provider Network Service Representative. This role serves as a key point of contact for providers and provider networks, delivering first-line support and issue resolution for network-related inquiries and initiatives. Responsibilities include responding to phone and email inquiries, regarding provider contracting, credentialing, and network participation status while ensuring a high level of customer service and support.

In addition to the core job requirements, our ideal candidates will have Facets experience. Training will be provided through a combination of job shadowing opportunities, hands-on learning, and collaboration with our Project Administrator and experienced team members. We are seeking an individual who is eager to learn, works well in a team environment, and is committed to providing exceptional service to our provider partners. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work — guided by proven workflows, templates, and policies.

Job Responsibilities

• Answering inbound customer service calls. Providing entry-level troubleshooting and redirecting phone calls when appropriate.
• Addressing minor provider issues and resolving minor complaints. Ensuring all customer communication is clearly documented.
• Identifying provider issues and determining the appropriate course of action for effective resolution.

Job Qualifications

Education

• High School Diploma or equivalent

Skills\Certifications

• Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint)
• Proficient oral and written communication skills
• Proficient interpersonal and organizational skills
• Ability to solve problems via the analysis and interpretation of conducting research
• Ability to work flexible hours in order to meet the needs of the business
• Able to handle multiple tasks and maintain expected performance
• Solid knowledge of the commercial health insurance market

Number of Openings Available

Worker Type:

Company:

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin,citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

Originally posted on Himalayas