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)
Responsible for administrative as well as clinical tasks, such as maintaining patient records, preparing patients and rooms for examination, assisting providers with exams, and performing front-desk tasks.
Organizational Relationship: Reports to the qualified Supervisor
High School graduate.
At least one year working experience, prefer in health care setting.
Excellent communication skills.
Must have criminal background check.
Answers phones, receives all intake information.
Takes telephone referral information when appropriate.
Handles all matters related to referrals, with the exception of issues that require professional/service delivery judgment.
Advise Supervisor of all new cases to be serviced.
Documents and reports to Supervisor when there is a change in client status, change in service requirement, change in employee assigned to case and any unsatisfactory performance.
Participates in the evaluation of field staff in regard to punctuality, reliability, assignments and related matters.
Telemarketing Agency services.
Is productive and uses time efficiently.
Follows instructions, is punctual and attendance is acceptable.
Cooperates with supervisor and with client/family.
Is self-reliant and plans appropriately.
Shows interest, asks questions and seeks information.
Other duties as required.
Must be able to read 12 point or larger type.
Must be able to hear adequately with no more than an amplifier on the phone and to speak in a manner understood by most persons.
Must be able to read, write and maintains simple records in English
Computer literate or willing to learn.