This Network Management Representative Position Features:
• Well Known
• Stable
• Dynamic
• Great Pay

Provides comprehensive services to the provider community through researching more complex provider issues. Primary duties may include, but are not limited to: Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction. Researches and resolves the complex provider issues and appeals for prompt resolution. Coordinates prompt claims resolution through direct contact with providers and claims department. May perform periodic provider on-site visits. Provides assistance with policy interpretation. Researches, analyzes and recommends resolution of provider disputes, issues with billing, and other practices. Assists providers with provider demographic changes as appropriate. Responds to provider issues related to billing, pricing, policy, systems and reimbursements. Identifies and reports on provider utilization patterns which have a direct impact on the quality of service delivery. Determines if providers were paid according to contracted terms. Requires a H.S. diploma or equivalent and a minimum of 3 years of customer service experience; or any combination of education and experience, which would provide an equivalent background. Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills strongly preferred.

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.