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:
- 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)
- Years of experience: 2 years
- Experience level:Experienced
Working hours: 8 AM - 6 PM
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