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Provider Relations Specialist

Company: Healthcare Support
Location: New York
Posted on: November 26, 2022

Job Description:

- Are you a Provider Relations Representative/Provider Contract Coordinator in New York looking for a new opportunity with a prestigious healthcare company? Do you want to work in the comforts of your home?* Do you want the chance to advance your career by joining a rapidly growing company? If you answered ???YES??? to any of these questions ??? this is the job for you! We are looking for a PROVIDER RELATIONS SPECIALIST! Day to Day Duties:

  • Assure that all provider orientations, site visits, access and availability studies are completed within designated timeframes; assure that all providers are visited within established timeframes.
  • Investigate and resolve member complaints regarding providers to maintain member and provider satisfaction; clarify the provider's problem; determine the cause of the problem; select and explain the best solution to solve the problem and expedite correction or adjustment; follow up to ensure resolution.
  • Assist Contract Management in identification of network deficiencies and make recommendations on how to address them.
  • Establish and foster strong, positive relationships with key providers by coordinating, facilitating, and leading partnership meetings and identifying onsite enrollment opportunities for Marketing.
  • Proactively identify provider needs and advise management so that action can be taken to address the needs before they are problematic for the provider.
  • Educate providers on the Plan???s provider incentive programs.
  • Educate providers on all billing requirements related to initial claims and corrected claims. Educate providers on the processes related to obtaining prior authorizations for services
  • Responsible for internal and external provider communications of program updates and changes to programs, including the provider manual and tip sheets Minimum Education/Licensures/Qualifications:
    • 3-5 years??? experience working in a managed care environment serving in Provider relations, Contract Management, or equivalent role, credentialing
    • Knowledge of various provider payment methodologies
    • Strong verbal and written communication skills
    • Valid Driver???s License
    • WFH capability ??? smart phone, private workspace, high speed internet - Covid-19 vaccination: Not required Length of Assignment: -Temp to perm Compensation Notes: $28 to $30 hourly Shift: M-F; 8:30AM to 5PM EST Start Date: 12/12; must be cleared by 11/30 Location: Remote in New York; Travel will be rare but will have milage reimbursement Hubs are located in Albany, Syracuse, Rochester, and Buffalo, stick to this general area (within 1 hr) - Advantages of this Opportunity:
      --- Competitive salary, negotiable based on relevant experience
      --- Benefits offered, Medical, Dental, and Vision
      --- Fun and positive work environment Interested in being considered? Should you be interested in this Pharmacy Technician position, please click the Apply button below or email your resume to jcesista@healthcaresupport.com Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Keywords: Healthcare Support, New York , Provider Relations Specialist, Other , New York, New York

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