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)
Position Highlights:
Position: Provider Relations Specialist
Location: Warrenville, IL
Part Time
Hours: M-F 8:30am-12:30pm
Responsible for the timely credentialing and re-credentialing updates of provider members in Behavioral Care Partners in accordance with requirements established by contracted Managed Care Organizations and NCQA. Under direction of Supervisor, is responsible for data entry of roster updates, hospital admissions, Quality Improvement studies, and the triage of member complaints related to Quality/Utilization Management referral issues. Provides network provider education and support with questions.
What you will need:
Required Education and/or Experience:
High level knowledge of computer skills and financial/statistical disciplines
Familiarity with fees schedules such as RBRVS, HCFC, RVU and CPT/HCPC codes
Preferred Education and/or Experience:
Bachelor's degree in business, finance or heathcare
Minimum three years previous managed care experience
Benefits:
Career Pathways to Promote Professional Growth and Development
Various Medical, Dental, and Vision options
Tuition Reimbursement
Free Parking at designated locations
Wellness Program Savings Plan
Health Savings Account Options
Retirement Options with Company Match
Paid Time Off and Holiday Pay
Community Involvement Opportunities
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0 Provider Relations Representative jobs found in Tinley Park, IL area