• Provider Network Analyst

    Job Locations US-FL-SUNRISE
    Posted Date 2 months ago(4/23/2018 9:20 AM)
    Requisition ID
    2018-3832
    Position Type
    Regular Full-Time
    Category
    Medical Bill Review
    Business Unit
    Broadspire
  • Excellence In Everything We Touch

    CrawCo Ole Miss

    Position Summary

     

     

    To coordinate a variety of business projects involving multiple functions within PPN. Obtain, organize and prepare operations information, ensure compliance to performance standards and key performance indicators. Communicate departmental information to internal and external customers.

     

     

    Responsibilities

     

    • Works with PPN management to effectively assist with the integration and provide overall coordination of PPN operations
    • Participates in the analysis of trends, including monitoring of operational processes to ensure effectiveness, efficiency and compliance with performance guarantees and key performance indicators
    • Provides measurement feedback to manager to assist with identification and development potential projects relating to network utilization
    • Assist in the development of policies and procedures in a standard operating procedure format under the direction of Team Manager; monitors, maintains, and updates Policy and Procedure information as necessary, at the direction of Team Manager
    • Assists business representatives in compliance and effectiveness audits of standardized models, procedures, and system requirements, utilizing existing auditing procedures
    • Participates in the planning and conducting of pilots and the development of training as requested
    • Participates in the identification, planning, and conducting of training programs for internal and external staff
    • Assists in the resolution of complaints, grievances, and customer issues as needed
    • Serve as department representative to other business units, or leased networks as needed
    • Keeps manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to manager for direction
    • Performs other related duties as required
    • Upholds the Crawford Code of Conduct

     

    Requirements

     

    • Bachelor’s degree in Business Administration, or the equivalent combination of education and related experience.
    • A minimum of two or more years of professional business analysis work experience that provided sound knowledge of Broadspire, Managed Care or the Insurance Industry is also required. Familiarity with bill review and/or managed care preferred.
    • Sound skills in fact gathering, analysis, and organization are necessary.
    • Must demonstrate effective and diplomatic oral and written communication skills, a good knowledge of software/hardware systems and how to relate business needs in data processing terms, and the ability to analyze problems and make recommendations.
    • Prior experience must include a demonstrated ability to manage projects involving coordinating, controlling and implementing as well as the ability to develop and deliver information in response to questions from management.

     

    About Us

     

    Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the United States. Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the United Kingdom (www.BroadspireTPA.co.uk).

    In addition to a competitive salary, Crawford offers you:

    • Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries;
    • On-going training opportunities through every stage of your career
    • Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.

    Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V

    Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means. 

     

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