Provider Relations Associate

  • location: Monterey Park, CA
  • type: Contract
  • salary: $20 - $24.14 per hour
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job description

Provider Relations Associate

job summary:
Provider Relations Associate - Monterey Park, CA

  • These are 5 positions expected to last 3 months.
Provider Relations Associate - Job Duties:

  • Deliver education and training effectively, but relies on their manager and higher level peers to improvise provider education messaging and strategic dealings with their assigned network
  • Coordinate escalated claim disputes and all necessary research timely and effectively, but can rely on their manager and higher level peers in setting action plans to analyze and resolve root cause
  • Implement or coordinate at least one geo-regional strategy that will result in operational efficiencies, with support and guidance from manager
  • Coordinate data extracts and data analysis interpretation in preparation of reports aimed to determine necessity of rate increases to retain key PPO providers, with support and guidance from peers or manager
  • With guidance with from higher level PRCs, the Associate level is required to work closely with its assigned IPA/Medical Group to ensure it is compliant with Access and Availability requirements
  • Complete Transition and Disengagement Reports required by Department of Manage Health care when IPAs/Medical Groups or Hospitals submit termination notices
Job Requirements:

  • The job requires minimum level of autonomy in decision making since the PRCs main customers (providers), need to rely on the PRCs for answers to issues that need immediate resolution
  • Bachelor's Degree preferred
  • Three years of experience in Healthcare Industry (Customer Service, Appeals, Sales)
Compensation: $20.00-$24.14.hr

 
location: Monterey Park, California
job type: Contract
salary: $20.00 - 24.14 per hour
work hours: 9 to 5
education: Bachelor's degree
experience: 2 Years
 
responsibilities:
Responsibilities:

-Deliver education and training effectively, but relies on their manager and higher level peers to improvise provider education messaging and strategic dealings with their assigned network

-Coordinate escalated claim disputes and all necessary research timely and effectively, but can rely on their manager and higher level peers in setting action plans to analyze and resolve root cause

-Implement or coordinate at least one geo-regional strategy that will result in operational efficiencies, with support and guidance from manager

-Coordinate data extracts and data analysis interpretation in preparation of reports aimed to determine necessity of rate increases to retain key PPO providers, with support and guidance from peers or manager

 
qualifications:
Qualifications:

-The job requires minimum level of autonomy in decision making since the PRCs main customers (providers), need to rely on the PRCs for answers to issues that need immediate resolution

-Bachelor's Degree preferred

-Three years of experience in Healthcare Industry (Customer Service, Appeals, Sales)

 
skills: Analysis
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

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