Provider Relations Specialist II

  • location: Rego Park, NY
  • type: Permanent
  • salary: $60,000 - $70,000 per year

job description

Provider Relations Specialist II

Are you looking for the next steps in your career? Take that first one by applying to be a Provider Relations Specialist II. If you have a positive, professional demeanor and understand the importance of making and keeping loyal customers happy, this opportunity is perfect for you! The ideal candidate has previous experience as a Provider Relations and experience with Medicare/Medicaid provider relations.   


Position Purpose: Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims • Conduct on-site provider orientations, including writing and updating orientation materials and assisting providers acclimated to plan website • Monitor financial performance of contracts • Investigate and document provider changes and correspondence • Coordinate with credentialing to ensure all appropriate documentation is received • Serve as a lead for key special projects • Recommend changes in pricing subsystems • Coordinate printing of provider directories with corporate and plan level entities • Investigate and respond to complex provider related issues and initiate change of provider related database information • Serve as a subject matter expert for provider relations activities and as a mentor for Provider Relations Specialist I staff • Ability to travel

The essential functions of this role include:

  • working weekends
  • Analytical Thinking
  • Verbal Communication
  • Medicare Compliance
  • Written Communication
  • Public Relations
  • Claims Processing (1 year of experience is required)
  • Customer Relations (5 years of experience is required)
  • Vendor Relations (5 years of experience is required)
  • Healthcare (1 year of experience is preferred)
  • Medicare/Medicaid (3 years of experience is required)
  • High School (required)
  • Years of experience: 2 years
  • Experience level:Experienced
Shift: First

Working hours: 8 AM - 6 PM

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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