Provider Relations

Contracting Coordinator

Responsible for administrative aspects of monitoring ancillary service contracts: pharmacy, durable medical equipment, physical therapy, home healthcare. Establish working relationships statewide with ancillary service providers and act as the primary liaison between PINNACOL ASSURANCE and vendors. Extensive interface building with internal personnel in Information Services and Strategic Business Groups including claim representatives, nurses, and Medpay processors. Must have comprehensive knowledge of ancillary service utilization in a managed care environment, preferably having some experience in a workers’ compensation setting. High School or GED with 2-4 years continuing education and/or experience in a related field. Minimum of three years of insurance or managed care experience, preferably in a workers’ compensation setting. Some of this experience will be directly related to contract support.

Medical Operations Assistant 

Responsible for the administrative support of the medical operations department, which includes: interface management of credentialing information; SelectNet directory update and maintenance; provider master file maintenance; and other support duties. High School Diploma or GED. Minimum of 2 years of general office experience, preferably in an insurance and/or medical facilities setting. 

Provider Relations Specialist

 Responsible for contracting, administration, implementation and monitoring of direct provider contracts, facility contracts and ancillary service contracts such as pharmacy, durable medical equipment, home health care, and others. Establish working relationships statewide with providers and ancillary service providers. Extensive interface building with internal personnel in Claims department, Med Pay Department and Information Systems. Conducts SelectNet contracting in designated geographic regions. Typically follows established policies and procedures; however, will also be required to exercise judgement in handling difficult situations that could benefit or put the Company at risk. Bachelor’s Degree from an accredited college or university in business, health care, insurance or a related field. Minimum of three years of insurance or managed care experience, preferably in a Workers’ Compensation setting. Some of this experience will be directly related to contracting.