Provider Relations Representative jobs in Colorado

Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Provider Relations Specialist I
  • CorVel Brand
  • Greenwood, CO FULL_TIME
  • The Provider Relations Specialist answers phone calls from injured workers, claims examiners, attorneys, and providers. The Provider Relations Specialist assist the caller to identify their reason(a) for calling and either answers their question(s) directly via accessing the CareMC bill review system to determine status of submitted bill or transfer calls as needed to appropriate CorVel staff.  This position includes a moderate to high volume of inbound and outbound calls.

    This position is remote.

    ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

    • Create -2 or > reviews as needed for incoming faxes and or bills received from provider offices as appeals to Denver COE bill reviews.
    • Receive incoming calls, emails and faxes from network.
    • Provide excellent customer service and act as network liaison to injured workers, claims examiners and providers.
    • Triage requests and ensure they are completed within required timeframes.
    • Follow all guidelines set by the Colorado, Idaho, Utah, New Mexico, and Montana regulations
    • Assist callers in navigating our website directory.
    • Answer questions from callers regarding CareMC bill review or transferring the caller to the appropriate department if we unable to assist.
    • Multi-task, utilize multiple programs and resources.
    • Various additional duties as assigned.

     

    KNOWLEDGE & SKILLS:

    • Ability to write and speak clearly, easily communicating complex ideas across multiple platforms
    • Ability to maintain composure in stressful situations and communicate diplomatically via telephone, fax, email or face to face interactions
    • Ability to work independently and prioritize tasks
    • Computer proficiency with the ability to utilize MS Office and other programs
    • Effective quantitative, analytical and interpretive skills
    • Strong interpersonal, time management and analytical skills
    • Knowledge of California Workers’ Comp regulations, not required

     

    EDUCATION & EXPERIENCE:

    • Associates’ degree preferred or comparable Workers Comp experience, typically level 2 Orange bill review skill set knowledge
    • Knowledge of assigned State’s Workers’ Comp regulations
    • CPC and/or expert in bill review analysis preferred
    • Call center experience a plus but not required

     

    PAY RANGE:

    CorVel uses a market based approach to pay and our salary ranges may vary depending on your location.  Pay rates are established taking into account the following factors:  federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions.  Our ranges may be modified at any time.

    For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.  The level may impact the salary range and these adjustments would be clarified during the offer process.

    Pay Range: $14.42 - $22.36 per hour

    A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

     

    ABOUT CORVEL:

    CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.  CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

    A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

    #LI-Remote

  • 20 Days Ago

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OCR Contract Case Consultant
  • Office of the Child's Representative
  • Colorado, CO FULL_TIME
  • ** This is for a contract with the Office of the Child's Representative. This is just for candidates fluent in Spanish. There are statewide opportunities, but we are in particular looking for candidat...
  • 20 Days Ago

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Social Worker
  • Office of the Child's Representative
  • Colorado, CO FULL_TIME
  • ****THIS POSTING IS STATEWIDE COLORADO. OCR IS LOOKING FOR CANDIDATES IN PUEBLO, DENVER, FOUR CORNERS area, FORT COLLINS, GREELEY, AMONG OTHER PLACES.****OCR MISSION & VISIONThe Office of the Child’s ...
  • 7 Days Ago

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Customer Relations Representative
  • GF Health Products, Inc.
  • Mountain, CO FULL_TIME
  • Company DescriptionPosition Summary Be part of the team that helps place and maintain our medical equipment/furniture in hospitals, nursing homes, ambulatory surgery centers, and in the homes of those...
  • 16 Days Ago

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Community Relations Representative
  • Springs Rescue Mission
  • Colorado, CO FULL_TIME
  • DescriptionSUMMARY OF POSITION:Springs Rescue Mission considers every position one of ministry and a vital and valued part of our team. Therefore, it is essential that all employees of SRM have a pers...
  • 19 Days Ago

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Temp Guest Relations Representative
  • Focus on the Family
  • Colorado, CO FULL_TIME
  • The Guest Relations Representative position exists to perform diversified functions associated with representing FOF to guests/constituents that visit the ministry through hospitality, greeting, provi...
  • 8 Days Ago

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Provider Relations Representative
  • MBI Health Services
  • Los Angeles, CA
  • Job Description Job Description Position Title: Provider Relations Representative Job Type: Full-Time / Hybrid Departmen...
  • 4/24/2024 12:00:00 AM

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Provider Relations Representative
  • University Health System
  • San Antonio, TX
  • Full Time 12238 Silicon Drive Professional Non-Nursing Day Shift POSITION SUMMARY/RESPONSIBILITIES Provider Relations Re...
  • 4/22/2024 12:00:00 AM

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Senior Provider Relations Representative
  • Molina Healthcare
  • Albuquerque, NM
  • ***Remote and must live in New Mexico*** Job Description Job Summary Molina Health Plan Network Provider Relations jobs ...
  • 4/22/2024 12:00:00 AM

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Provider Relations Representative
  • American Health Plans
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 4/20/2024 12:00:00 AM

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Provider Relations Representative
  • American Health Plans
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 4/20/2024 12:00:00 AM

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Provider Relations Representative
  • Phoebe Health
  • Albany, GA
  • Description JOB SUMMARY * Serves as a liaison between PHP providers and the organization to meet provider network servic...
  • 4/20/2024 12:00:00 AM

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Medicare Provider Relations Representative
  • The Cigna Group
  • Wilmington, DE
  • SUMMARY: This position is an external provider facing role with account management responsibilities for a medium to low ...
  • 4/20/2024 12:00:00 AM

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Medicare Provider Relations Representative
  • The Cigna Group
  • Pittsburgh, PA
  • SUMMARY: This position is an external provider facing role with account management responsibilities for a medium to low ...
  • 4/20/2024 12:00:00 AM

Colorado (/ˌkɒləˈrædoʊ, -ˈrɑːdoʊ/ (listen), other variants) is a state of the Western United States encompassing most of the southern Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains. It is the 8th most extensive and 21st most populous U.S. state. The estimated population of Colorado was 5,695,564 on July 1, 2018, an increase of 13.25% since the 2010 United States Census. The state was named for the Colorado River, which early Spanish explorers named the Río Colorado for the ruddy silt the river carried from the mountains. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$54,631 to $69,892