Practitioner Updates Specialist

Description/Responsibilities

WholeHealth Living® is a Tivity Health® company focused on delivering cost-effective integrative health solutions, connecting members with qualified licensed practitioners, and educating the broader medical community on the importance of integrating nonpharmacological options to patient care. WholeHealth Living offers a variety of solutions to support health plans and the health and well-being of its members. We have three unique products: Integrative Health Solutions, Choices by WholeHealth Living, and Pain Care Solution. Learn more at www.wholehealthliving.com.

• Evaluate, process, and enter practitioner data, including demographic updates, attestation data review, in WHL data management systems.
• Conduct practitioner outreach by phone and/or email to obtain clarification or additional information to complete updates, as well as confirm changes, while demonstrating the ability to serve in a customer-facing role through a relationship-driven style focusing on practitioner satisfaction and retention.
• Process practitioner network terminations and network additions, including written notifications to practitioners of applicable changes.
• Demonstrate proficient understanding of all health plan network requirements and required criteria for each specialty
• Research and process assigned task requests within 3-5 days.
• Manage a high volume of data change requests while meeting case closure deadlines.
• Understand and follow all department policies and procedures pertaining to processing and administration of practitioner applications.
• Manage the practitioner updates email box and respond to practitioners within 3-5 days.
• Run and distribute various data audit reports, as required.
• Educate practitioners on current, new, or revised policies and procedures for all lines of business, as applicable.
• Interact professionally with colleagues and practitioners.
• Other duties, as assigned.

Qualifications

• High school diploma or GED required, associate or bachelor’s degree preferred.
• Three plus years of experience working in provider relations and/or data entry required.
• Strong attention to detail
• Excellent verbal and written communication skills
• Demonstrated ability to serve in a customer-facing role through relationship-driven style in building effective network satisfaction
• Strong analytical and problem-solving skills
• Proficiency using Microsoft Office products (Word, Excel, Outlook)
• Ability to adapt to new responsibilities and changes when necessary
• Ability to organize, plan and schedule workload to meet objectives 
• Ability to work independently and also contribute toward team efforts
• Knowledge of practitioner demographic and billing practices preferred
• Experience with government payers including Medicare and State Medicaid
• Experience in a highly transactional caseload environment.

The hourly range for this opportunity is $21/hr to $28/hr. Compensation depends on several factors: qualifications, skills, competencies, and experience.

Tivity Health offers a robust benefits package, which includes a competitive salary, company bonus potential, medical, dental, vision, 401k with match, generous paid time off, free gym membership to over 13,000 fitness locations in the US, and other great benefits.

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About Tivity Health® Inc. Tivity Health, Inc. is a leading provider of healthy life-changing solutions, including SilverSneakers®, ForeverFit®, and WholeHealth Living®. We help adults improve their health and support them on life's journey by providing access to in-person and virtual physical activity, social and mental enrichment programs, as well as a full suite of physical medicine and integrative health services. Our suite of services support health plans, employers, health systems and providers nationwide as they seek to reduce costs and improve health outcomes. Learn more at TivityHealth. 

Tivity Health is an equal employment opportunity employer and is committed to a proactive program of diversity development.  Tivity Health will continue to recruit, hire, train, and promote into all job levels without regard to race, religion, gender, marital status, familial status, national origin, age, mental or physical disability, sexual orientation, gender identity, source of income, or veteran status.