Do you have previous sales, provider relations, or contracting experience and a knowledge of healthcare? Are you ambitious, a self-starter and willing to travel in the future up to 3 days per week working as a liason between providers? If so then this may be the position for you! Our client is currently looking to fill a Provider Relations Specialist for thier organization and are looking for that motivated individual to add to their rockstar team. As a Provider Relations Specialist you would be performing duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices. If you feel you may be a good fit then please apply now so we can get to know you more!
• Serve as primary contact for providers serving as a liaison between the provider and the health plan
• Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on •site and routing to the appropriate party for resolution
• Receive and respond to external provider related issues
• Initiate entry or change of provider related database information and oversee testing and completion of change request
• Investigate, resolve and communicate provider claim issues and changes
• Educate providers regarding policies and procedures related to referrals and claims submission, web site education, EDI solicitation and problem solving
• Perform provider orientations, including writing and updating orientation materials
• Ability to travel
- Medical Software
- Analytical Thinking
- Written Communication
- Verbal Communication
- Medicare Compliance
- Years of experience: 3 years
- Experience level:Experienced
Working hours: 8 AM - 4 PM
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