MagnaCare is seeking experienced Provider Liaisons to serve as the point of contact among providers, clients, and internal stakeholders to ensure seamless network operations.
Primary Responsibilities
Act as a liaison between providers and the organization to address concerns, resolve issues, and promote smooth communication.
Employ strong knowledge of medical coding systems—including CPT Codes, HCPCS Codes, ICD-10 Codes, and Modifiers—to assist in claims-related inquiries.
Initiate and maintain effective channels of communication with clients and internal stakeholders.
Address escalated accounts receivable and reimbursement issues and ensure that claims are processed accurately and providers understand the reasons for claim denials when they occur.
Provide network reporting and analysis to support network needs.
Help identify opportunities for process improvements.
Maintain repository containing various reporting elements including but not limited to AR issues, claim disputes, memos, issues, etc.
Adhere to HIPAA guidelines and regulations through daily job functions.
Essential Qualifications
Bachelor's degree or equivalent work experience, preferably in healthcare.
Strong understanding of provider contracting, claims, and network compliance.
Advanced claim-processing research, including professional, facility, and ancillary claims.
Strong knowledge of claim processing, such as CPT Codes, HCPCS Codes, ICD-10 Codes, etc.
Diverse analytical and interpersonal skills.
Ability to maintain a professional demeanor through written and verbal correspondence.
Organizational skills, with a proven ability to work independently and in team settings.
Adhere to HIPAA guidelines and regulations through daily job functions.
Proficiency in Microsoft Office (Word and Excel).
At MagnaCare LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect, and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities.
For more than 30 years, MagnaCare LLC has been a trusted partner in delivering flexible, customized solutions for self-insured organizations. As a national third-party administrator (TPA), we combine proprietary technology, network expertise, and a deep understanding of labor to help our clients achieve their goals while supporting the people they serve.
Our focus on labor means we work closely with funds, Taft-Hartley Trusts, and other self-insured groups to deliver tailored solutions that go beyond the basics. From health plan administration and eligibility management to contribution accounting, we provide the tools and support organizations need to succeed. With specialized offerings such as flexible network administration, direct contracting, in-house medical and care management, and workers’ compensation programs, we create benefit plans that address unique needs with precision.
