Network Outreach Specialist

Job not on LinkedIn

🔥 1 minute ago

🦌 Connecticut, New Jersey, +2 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🔔 Pennsylvania – Remote

💵 $50.1k - $67.1k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 15%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Gather attestation and validation on the accuracy of provider network data as displayed in local directories. • Make outbound validation calls to providers regarding demographic practitioner details for each practice location across Horizon networks. • Contact members regarding preventive health activities. • Receive inbound service calls and provide accurate, complete information in response to provider inquiries, complaints and problems. • Contact provider offices to encourage ongoing education and dialogue on data management best practices and attend scheduled orientation and educational outreach activities. • Conduct provider surveys and assessments as applicable. • Act as liaison with providers, members and outside community resources. • Handle PCP/PCD changes for members. • Verify PCP/PCD and member eligibility with providers. • Maintain call documentation in databases for special outreach projects. • Assist provider offices with credentialing, recredentialing, claims and provider data maintenance issues by providing process guidance. • Ensure compliance with DOBI, CMS and NCQA accuracy regulations.

🎯 Requirements

• High School Diploma/GED required. • Requires a minimum of 3 years of experience in customer service, telephone sales preferably in a Managed Care environment. • Some experience with provider practices, physicians and/or office managers in a healthcare, group practice setting. • Prefers knowledge of Horizon products and services. • Requires knowledge of health insurance industry. • Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes. • Should be knowledgeable in the use of intranet and internet applications. • Requires excellent oral and written communication skills. • Requires strong interpersonal and organization skills. • Requires ability to resolve problems. • Employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware.

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement