RanchoCordovaRecruiter Since 2001
the smart solution for Rancho Cordova jobs

Provider Relations Specialist

Location: Rancho Cordova
Posted on: June 14, 2020

Job Description:

Job Title: Provider Relations Representative




JOB SUMMARY:



Primary job responsibilities involve assisting the Provider Relations Managers with the providers and the provider network. Respond to provider related inquiries received by letter, phone, or internal departments. Assures providers receive exceptional service and response level. Reviews and monitors provider complaints, grievances and escalate issues as necessary to the appropriate Provider Relations Manager. Prepares provider blast fax for newsletters/bulletins. Assist with departmental administrative tasks, as needed. Must be flexible and disciplined enough to multi-task while handling a variety of duties. Attend local Open Enrollment Meetings as appropriate to support clients and providers.



DUTIES AND ACCOUNTABILITIES:



? Initial contact and responder to provider related inquiries received by letter, phone, or internal departments.


? Work closely with Provider Relations Managers to assure providers receive exceptional service and response and escalate issues as necessary.


? Provide continual evaluation of processes and procedures in the department and suggest methods to improve efficiency and service for providers.


? Resolve member incident reports and provider complaints and demonstrate the ability to be resourceful in problem solving.


? Update changes in provider?s practice information such as TIN?s and addresses.


? Assist in recruitment projects, network comparisons and data entry


? Process all outgoing application packets and follow-up letters on a weekly basis.


? Distribution of Provider Bulletins & Newsletters


?Resolve claims issues related to insufficient provider information and make necessary corrections and update databases.


? Administer accurate data entry into multiple provider systems including Access and claims processing systems.


? Assure providers have the appropriate training and resources by participating in provider office education.


? Attend local Open Enrollment Meetings as required to support clients and providers.


? Establish work procedures and processes for Provider Relations that support company and departmental standards and strategic directives.


? Perform other related duties as assigned.



QUALIFICATIONS/REQUIREMENTS:



Education: High school graduate. Two to three years of college or equivalent.



Experience: Requires 7+ years administrative experience. Preferably previous health care experience in a managed health care environment, provider relations or customer service,


including working with members and providers. Excellent computer skills and proficiency with word processing and spreadsheets. Also requires excellent verbal and written communication skills to communicate with providers via phone and written correspondence. Experience and ability to prioritize multiple tasks appropriately. Understanding of vision care insurance is a plus.



We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

Keywords: , Rancho Cordova , Provider Relations Specialist, Healthcare , Rancho Cordova, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Speech Language Pathologists- San Rafael, California
Description: Soliant Health is seeking to fill a Speech Language Pathologists opportunity within a school district in San Rafael, California
Company: Soliant Health
Location: San Rafael
Posted on: 07/4/2020

Telemetry RN Needed For A 13 Week Contract
Description: Skyline Med Staff is looking for some of the most talented nurses in the industry to fill 13 week and longer contract assignments. Skyline Med Staff offers one of the best competitive pay packages
Company: Skyline Med Staff
Location: San Rafael
Posted on: 07/4/2020

Emerald Health Services is looking for Travel Nurse Rn Home Health Home Care in Woodland
Description: Travel Nurse Rn Home Health Home Care - Emerald Health ServicesThis is a travel Nurse - Home Health assignment in Woodland, CA,
Company: Emerald Health Services
Location: Woodland
Posted on: 07/4/2020


Travel RN-Homehealth Nurse - Travel Home Health Nurse Needed in San Ramon, CA, Skill Required
Description: We are seeking an experienced and self-motivated Home Health RN to join our growing team of nursing professionals Home health nurses provide nursing services for persons who are home-bound and physically (more...)
Company: Foundation Medical Staffing
Location: San Ramon
Posted on: 07/4/2020

Home Health Nurse - Travel - (HH RN)
Description: Job Description RequirementsHome Health Nurse - HH RN StartDate: 07/06/2020Available Shifts: 8 D Pay Rate: 0.00 - 0.00HH RN needed for 13 weeks in Woodland, CARequired QualificationsCA RN number (more...)
Company: American Mobile Healthcare
Location: Woodland
Posted on: 07/4/2020

Travel Nurse Rn Home Health Home Care
Description: Travel Nurse Rn Home Health Home Care - Emerald Health ServicesThis is a travel Nurse - Home Health assignment in Woodland, CA,
Company: Pure Job Alerts
Location: Woodland
Posted on: 07/4/2020

Time To Re Build with Travel Nurse Rn Home Health Home Care at Emerald Health Services Now Hiring
Description: Travel Nurse Rn Home Health Home Care - Emerald Health ServicesThis is a travel Nurse - Home Health assignment in Woodland, CA,
Company: Emerald Health Services
Location: Woodland
Posted on: 07/4/2020

California Speech Language Pathologist
Description: There is a school district near San Rafael, CA that is hiring a SLP for the upcoming school year. Interested applicants are encouraged to apply br br
Company: Soliant Health
Location: San Rafael
Posted on: 07/4/2020

Urgent requirement for Travel Nurse Rn Home Health Home Care in Woodland
Description: Travel Nurse Rn Home Health Home Care - Emerald Health ServicesThis is a travel Nurse - Home Health assignment in Woodland, CA,
Company: Emerald Health Services
Location: Woodland
Posted on: 07/4/2020

Travel Nurse RN - Home Health
Description: About the jobCross Country Nurses is seeking a travel nurse RN Home Health for a travel nursing job in Woodland, California: br ul br li Specialty: Home Health li Discipline: RN li Start Date: (more...)
Company: NurseFly
Location: Woodland
Posted on: 07/4/2020

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Rancho Cordova RSS job feeds