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Network Education Rep Sr_

Indianapolis

**Location: Indianapolis, IN**

**Hours: Standard M - F**

**Travel:** **Hybrid (1-2 days in office per week) – Travels to worksite and other locations as necessary.**

**Position Overview:**

LTSS Claims Educators who are in Indiana and facilitate the exchange of information between the grievances, claims processing, and provider relations systems. This position works closely with the Network Education Rep to develop training content specific to LTSS provider claims, to be incorporated into LTSS provider onboarding and continuing education. As well as tracking and trending LTSS claims data, providing technical assistance and ad-hoc training to LTSS providers both virtually and in-person.

**How You Will Make an Impact:**

+ Educating contracted and noncontracted providers (professional and institutional) regarding appropriate claims submission requirements, coding updates, electronic claims transactions, and electronic fund transfer

+ Educating contracted and non-contracted providers on available Contractor resources such as provider manuals, website, fee schedules, etc

+ Interfacing with the Contractor’s call center to compile, analyze, and disseminate information from provider calls

+ Identifying trends and guiding the development and implementation of strategies to improve provider satisfaction; and frequently communicating with providers, including conducting on-site visits, to assure the effective exchange of information and gain feedback regarding the extent to which providers are informed about appropriate claims submission practices

+ Provides/coordinates provider training for claims and billing procedures and contract compliance

+ Supports the contractual agreements with all providers to ensure compliance with local/state/federal regulations

+ Provides leadership in the development, implementation and evaluation of provider operations, contracting and issue resolution strategies

+ Reviews state and national programs, trends and literature regarding provider issues and recommend appropriate strategies

**Required Qualifications:**

+ Requires a BA/BS degree and a minimum of 4 years experience; or any combination of education and experience, which would provide an equivalent background

**Preferred Qualifications:**

+ Prior experience as an LTSS or HCBS provider or in a provider office is preferred

+ Intermediate Excel experience strongly preferred

+ SQL experience preferred

+ Experience training or mentoring preferred

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