Provider Education Specialist

Job Summary

The Provider Education Specialist is responsible for developing and delivering initial and ongoing training for providers. This includes preparing educational programs and educational resource materials, responding to questions from providers related to contract provisions, Blue Cross Blue Shield of North Dakota (BCBSND) provider processes, etc. and acts as a liaison between BCBSND and the provider community.

 

Essential Functions

• Coordinates outreach and provides initial training to new provider business office staff with regard to use of website, claims submission, provider manual content and potential challenges and issues.
• Responds to questions regarding interpretations of contract provisions and refers substantive or complex questions to appropriate staff.
• Develops specialized training via webinar or teleconference to address emerging technical or administrative issues, e.g. coding changes, new treatment policies, etc.
• Develops and maintains effective working relationships with key business office personnel in provider community by building credibility, establishing trust, and collaborating on issues and concerns.
• Facilitates and participates in internal and external clinic and hospital meetings and/or conference calls with billing staff to act as a liaison between the provider and BCBSND.
• Serves as a resource to internal departments in resolving complex claim issues and/or provider disputes.
• Maintains knowledge base of BCBSND programs, benefits, billing and coding guidelines, and other Plan policies and procedures to provide the most current information available and serve as a resource to internal departments and the provider community in resolving complex claim issues and/or provider disputes.

 

Knowledge, Skills and Abilities

Attention to Detail and Accuracy

Intermediate

Organizational Understanding

Intermediate

Effective Interpersonal Communications

Advanced

Presentation Skills

Intermediate

Formal Written Communications

Intermediate

Education Requirements

Required: Associate's

Preferred: Bachelor's

Field(s) of Study: Healthcare, Business or related field

 

Experience Requirements

Required: Minimum of 4 Years

Preferred: Minimum of 6 Years

Experience Details: Minimum of 4 years of experience in healthcare or health insurance is required; experience in provider service or provider relationships is strongly preferred (e.g. in health insurance or in a service provider business office).

 

Certification, Licensures & Registration Requirements

Title: N/A

State or Agency: N/A

 

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Other Information

Important Notice: BCBSND has a vaccination protocol in place that requires any employees who physically work in a BCBSND office or whose role requires direct customer contact to be vaccinated against COVID-19. We respect your choice to get vaccinated (or not) and getting vaccinated is not a condition of employment. If you are not vaccinated, you may work remotely if your role allows for it. If your role does not allow for remote work and you are unable to get the COVID-19 vaccine, there is an exception process available that includes a weekly testing regimen.

Job Posting Policy 

New employees with Blue Cross Blue Shield of North Dakota will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

Equal Opportunity Employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com

This job posting will be closed 11/11/2021 at 8:00AM CST. No further applications will be considered.