Casualty, Support Specialist

Location: Remote

• Educate providers on current policies, trends and information affecting their participation within the MagnaCare network.
• Act as liaison for interpretation of No-Fault and Workers Comp contracts.
• Respond to inquiries specifically related to the provider’s contract or claim issue.
• Research provider contract/claim issues received by the provider or the client, and perform claims analysis.
• Maintain database for provider issues and creating detailed reports as needed.
• Log credentialing applications and assist with the Casualty enrollment process.
• Negotiate solutions and resolve conflicts in a manner that will insure client/provider satisfaction.
• Maintain provider network by negotiating/retaining key providers.
• Surface issues and work with interdepartmental representatives to establish plans for resolution.
• Coordinate efforts with members of the management team in developing short and long term plans that result in high performance provider services.
• Assist in the development and update of provider panels.
• Provide back-up and support to other Casualty departments, including Care Coordination.
• Assist with Provider and/or Customer Implementations as needed.

• Superior oral and written communication skills.
• Strong PC skills (excel is a must).
• Knowledge of the health insurance industry, products and services.
• Familiarity with claims and claims processing.
• Strong follow up, negotiating and influencing skills.
• Excellent problem solving skills.
• Capable of managing multiple complex issues.
• Ability to maintain professional demeanor under pressure.
• Work well independently and as a team player.
• Minimum of two years experience.
• Bachelor degree or equivalent experience.