Provider Relations Representative Job at ArchCare
Overview:
Work Experience
The Provider Relations Representative will be responsible for providing support in the recruitment, implementation and servicing of individually contracted providers and vendors. In addition the representative is accountable for training and orientation of providers in contracted areas. The Provider Relations Representive is also required to have an understanding of reimbursement methodologies, negotiation strategies, and provider service experience in a managed care environment.
Responsibilities:
The Provider Relations Representative will be responsible for:
- Assisting with ongoing provider gap analysis and continually analyzes network needs.
- Recruits and maintains a network of providers.
- Support provider offices with electronic claim submission.
- Manage effective provider-specific quality metrics, action plans, and process improvement intiatives.
- Assists in the investigation and response of complaints regarding providers or provider services.
- Adheres to required response time as outlined in policy and procedures.
- Participate in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals.
- As required by changing business needs, complete additional responsibilities as assigned.
- Additional responsibilities as needed.
Salary: $55-60K based on education, experience, and training.
Qualifications:
Education
- Bachelor's Degree or equivalent combination of education and managed care experience in provider service are preferred.
Work Experience
- Proficient in Microsoft Windows including Excel, Word, and Access applications.
- Proficiency in Data Entry and Provider Data Management
- PowerBI experience preferred.
- Working knowledge of provider credentialing and compliance.
Archcare is an equal opportunity employer.
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