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Provider Relations Coordinator Jobs

Provider Relations Representative - Remote | Wfh
By Get It Recruit - Healthcare At San Antonio, TX, United States

We are seeking a Provider Relations Representative (PR Rep) to join our dynamic team. As a PR Rep, you will play a pivotal role in managing our assigned Provider Network, forging strong partnerships ...

Senior Provider Relations Representative
By BlueCross BlueShield of South Carolina At United States
Produces/generates various reports to management and provides feedback on activities to management.
Bachelor's degree OR Four (4) years of job-related work experience OR Four (4) years combined job related education and experience.
Four (4) years of experience in customer service, claims processing, communications, education/training, provider relations, healthcare or combination. (Can be concurrent)
Develops/prepares/reviews/updates all provider education materials.
Performs administrative functions in support of education and training.
Demonstrated skills related to training materials development.
Provider Utilization Coordinator Sr
By QTC Management, Inc. At , San Antonio, 78228 $21 - $23 an hour
Experience utilizing EMR or case management software
Effective management of electronic confirmation systems (i.e. eMessenger, Pega communicator, ACD) in order to minimize no show rates
Excellent data entry and typing skills
Ability to coordinate with regional utilization manager (RUM) on IPA utilization issues
Efficiently utilizes electronic tools and workflows in order to manage resources such as: ECW, UCM, eProcess and other tools as necessary
Excellent communication skills in English, both written and verbal
Provider Relations Representative Opening For Central Phoenix Market
By Southwest Medical Imaging, LTD At Scottsdale, AZ, United States
Consistently demonstrates competency and leadership through effective management of territory by utilizing individual business plan. Referral Volume Data
Demonstrate competency in correctly entering appropriate data each month to update individual plan. Visit Planning
Utilize rolling computer bags, organization of vehicle trunk Community Marketing Presentation Efforts Health Fairs/Special Events
Provider Relations Professional - Bh
By Humana At ,
Exceptional written and verbal communication and relationship management skills
Ensure compliance with Louisiana's managed care contractual requirements for provider relations, such as claims dispute resolution within specified timeframes
Proven working knowledge of Behavioral Health provider operations, competitor strategies, financial/contracting arrangements, and/or regulatory requirements
Develop and maintain Behavioral Health provider relationships to optimize provider experience and satisfaction
Experience working with behavioral health providers and substance use providers
Understanding of behavioral health managed care and how services are delivered
Provider Relations Manager Jobs
By DynamiCare Health At Pittsburgh, PA, United States
Prepare and maintain up-to-date enrollment workflows consistent with requirements of specific implementations.
Pull and distribute monthly reporting per requirements of individual provider contracts.
An active Counseling License (OMSAS) or Substance Use Disorder Certification (Pennsylvania Certification Board) is strongly preferred.
Previous experience (2+ years) working in the SUD (addictions) profession
Knowledge of substance use disorders; if in recovery, at least 2 years of sustained recovery
Excellent oral and written communication skills, organizational skills, and high attention to detail
Provider Grid Operations Coordinator
By ApolloMed At Monterey Park, CA, United States
Detail oriented and have good organizational skills
Environmental Job Requirements and Working Conditions:
Review providers add, termination, and demographic update requests.
Maintain and update providers’ health plan unique identification numbers across all lines of business.
Identify providers’ data error and coordinate with responsible parties to correct.
Accurately log all providers’ requests and be able to provide monthly summary to Director and Team Lead.
Provider Relations Specialist Jobs
By Mom's Meals At Ankeny, IA, United States
Assist in continual training to assigned providers on best practices and other resources to assist with claims, authorizations, member benefits, etc.
Strong communication skills and ability to use appropriate tact and finesse when dealing with delicate issues
Strong organizational skills to coordinate new partnerships and keep processes moving
Ability to think outside the box and offer new suggestions for integrating new procedures
Experience working in a healthcare, provider or HMO/PPO environment familiar with billing claims and authorization processes
Position Responsibilities may include, but not limited to
Provider Relations Manager Jobs
By CareMax, Inc. At Brockton, MA, United States
Proactive, analytical relationship management expert
Strong organizational and planning skills to manage multiple priorities and meet required deadlines
Access to continual education through CareMax University
Experience working with VBCs (value based contracts)
Minimum of three (3)– years of provider network operational experience
Strong analytical, critical thinking and problem solving skills to ensure process improvement and projects are completed successfully
Provider Relations Specialist Jobs
By Insight Global At Springfield, Massachusetts Metropolitan Area, United States
Detailed orientated problem solver with excellent time management skills and ability to meet filing due dates
Associates Degree in Health Administration, Business Administration, Regulatory Science or an equivalent combination of education and work experience in related field.
Two to three years of experience working in health insurance and regulatory industry
Strong writing, communication and interpersonal skills
Health insurance industry experience preferred
Participate in oversight calls with PPO Networks and vendors to coordinate regulatory compliance and document meeting minutes that meet regulatory guidance.
Provider Relations Representative Jobs
By Fallon Health At Worcester, MA, United States
Develop and maintain positive and productive rapport with Fallon Health providers through proactive relationship management and communications.
Escalate conflicts to Manager of Provider Relations and when appropriate Director, Provider Relations.
Co-lead internal and external Joint Operations Committee meetings with contract managers.
Proficiency with desktop computer applications, Microsoft Office package and Mainframe knowledge (i.e. QNXT, IDX etc.)
Clear and concise written and verbal communication skills
Serve as primary Fallon Health contact for providers to resolve issues relating to the administration and operation of providers' contracted services.
Provider Relations Associate Jobs
By CareMax, Inc. At Orlando, FL, United States
Proactive, analytical relationship management expert
Strong organizational and planning skills to manage multiple priorities and meet required deadlines
Access to continual education through CareMax University
Experience working with VBCs (value based contracts)
Minimum of three (3) – years of provider network operational experience
Strong analytical, critical thinking and problem solving skills to ensure process improvement and projects are completed successfully
Director, Network Management (Provider Relations) (Director Ii)
By CalOptima At Orange, CA, United States
Bachelor’s degree in Health Care Management or a related field required.
5 years of progressive leadership experience, including direct supervision of staff, in managed care, providers or health plans required.
Medicaid managed care, Medicare risk-contract, or commercial Health Maintenance Organization (HMO) insurance experience required.
Master’s degree in Health Care Management or related field.
Medi-Cal managed care plan experience or related government client or public sector experience.
Directs training of providers to promote cost-effective managed care, compliance, and enhancement of service standards.
Provider Relations Specialist Jobs
By Mindlance At United States
100% Remote/ Work from Home
·The main purpose of this role is to reschedule all canceled appointments either by patient are provider.
·Strategize, coordinate, create and execute Provider schedules efficiently and effectively.
·The Candidate must be comfortable making 200+ outbound calls a day and working in an independent environment.
·Reschedule all appointments canceled either by patient are provider.
·Establish concierge level relationships with assigned providers.
Provider Relations Manager Jobs
By Connect Chiropractic At Wauwatosa, WI, United States
Requirements For a Provider Relations Manager
Experience in marketing, sales, or networking
OUR IDEAL PROVIDER RELATIONS MANAGER
Public Speaking Abilities Are Preferred.
Customer service driven - Eager to help customers find solutions regardless of challenges
Respectful - Treats others with kindness and is positive and helpful
Director Of Provider Relations
By DynamiCare Health At Massachusetts, United States
Prepare and maintain up-to-date enrollment workflows consistent with requirements of specific implementations.
Pull and distribute monthly reporting per requirements of individual provider contracts.
Prior experience in behavioral health/substance use disorder treatment
Highly self-motivated and capable of communicating virtually with not only providers but also your team and manager
Excellent telephone and written communication skills
Strong organizational skills, process oriented and attention to detail
Provider Relations Manager- Remote
By Prime Therapeutics At , Remote $59,610 - $95,370 a year
Bachelor's degree in a related field, or at least 4 additional years of experience in healthcare, network development, network management.
5-8 years experience in a Provider Relations role for a managed care plan.
Takes the front-line in establishing and maintaining strong communications with providers. Collaborates with Regional Managers and manages staff and support activities.
Solid knowledge of health plan operations required.
Assists with network strategy committee meeting and network application processing decision committees
Collaborates and monitors with credentialing teams to ensure provider compliance with provider and state contracts.
Remote Provider Relations Representative**
By Cotiviti At , Remote $17.50 an hour
High school diploma, GED, or equivalent work experience
Initiates phone calls to customers, (providers/pharmacies/patients/carriers etc.) to confirm receipt of mailings, and to request action.
Provides timely response and resolution for all provider initiated inquires (phone calls, emails or faxes).
Reviews and analyzes documentation and claim data to determine validity and proper action.
Updates accounts receivable system with denial and group information.
Assists with high priority special projects
Provider Relations Manager- Remote
By Prime Therapeutics At Minneapolis, MN, United States
Bachelor's degree in a related field, or at least 4 additional years of experience in healthcare, network development, network management.
5-8 years experience in a Provider Relations role for a managed care plan.
Takes the front-line in establishing and maintaining strong communications with providers. Collaborates with Regional Managers and manages staff and support activities.
Solid knowledge of health plan operations required.
Assists with network strategy committee meeting and network application processing decision committees
Collaborates and monitors with credentialing teams to ensure provider compliance with provider and state contracts.
Provider Integration Coordinator Jobs
By Inova Health System At ,
Experience with provider credentialing and management of the onboarding process
Supports work streams associated with provider integration which may include change management initiatives, system development initiatives, program implementations, etc.
Serves as support for staff and peers for educational and professional skills within the onboarding space.
Draws valid conclusions for recommendation to management for decision making to suggest potential alternatives using data analysis.
Superior Critical Thinking Skills and Ability to take a proactive approach
Supports the effectiveness of each programs processes and timelines, collaboratively working with the Directors of Operation and Hiring Managers.

Are you looking for an exciting opportunity to join a growing team and make a real impact? We are looking for a Provider Relations Coordinator to join our team and help us build strong relationships with our providers. You will be responsible for managing provider contracts, resolving provider issues, and ensuring compliance with all applicable regulations. If you have excellent communication and organizational skills, this could be the perfect job for you!

Overview Provider Relations Coordinators are responsible for maintaining relationships with providers and ensuring that they are providing quality services to clients. They are responsible for developing and maintaining relationships with providers, monitoring provider performance, and resolving any issues that arise. They also provide support to providers and clients, and ensure that all services are being provided in accordance with the organization's standards. Detailed Job Description Provider Relations Coordinators are responsible for developing and maintaining relationships with providers, monitoring provider performance, and resolving any issues that arise. They are responsible for ensuring that all services are being provided in accordance with the organization's standards. They must also provide support to providers and clients, and ensure that all services are being provided in a timely and efficient manner. They must also be able to identify and address any potential issues that may arise. Provider Relations Coordinators must have excellent communication and interpersonal skills, as they will be interacting with both providers and clients. They must also be able to work independently and be able to handle multiple tasks at once. They must also be able to work well under pressure and be able to handle difficult situations. Job Skill Requirements
• Excellent communication and interpersonal skills
• Ability to work independently and handle multiple tasks
• Ability to work well under pressure
• Ability to handle difficult situations
• Knowledge of provider relations and services
• Knowledge of relevant laws and regulations
• Knowledge of customer service principles
• Knowledge of data analysis and reporting
• Knowledge of computer systems and software
• Ability to work with a variety of people
Job Qualifications
• Bachelor’s degree in business, healthcare administration, or related field
• At least two years of experience in provider relations or customer service
• Knowledge of relevant laws and regulations
• Knowledge of customer service principles
• Knowledge of data analysis and reporting
• Knowledge of computer systems and software
• Ability to work with a variety of people
Job Knowledge Provider Relations Coordinators must have a thorough understanding of provider relations and services, as well as relevant laws and regulations. They must also have knowledge of customer service principles, data analysis and reporting, and computer systems and software. Job Experience Provider Relations Coordinators must have at least two years of experience in provider relations or customer service. Job Responsibilities
• Develop and maintain relationships with providers
• Monitor provider performance
• Resolve any issues that arise
• Provide support to providers and