Premium Healthcare is looking for a provider relations representative to liaise with healthcare providers and clients on healthcare-related issues, of which the majority are related to claims and provider participation.

To ensure success as a provider relations representative, you should be highly organized and have excellent communication skills. Ultimately, a top-notch representative should resolve queries and train healthcare providers to ensure operational efficiency.

Provider Relations Representative Responsibilities:

Initiating and maintaining effective channels of communication with service providers and clients.
Gathering, reviewing, and verifying all pertinent information relating to participating healthcare providers.
Establishing and maintaining relationships with assigned healthcare providers through office visits, telephone calls, prompt resolution of issues, and excellent customer service.
Conducting training of service providers on policies, procedures, service lines, and available technology.
Answering questions from doctors' offices on benefits.
Gathering, reviewing, and submitting relevant documentation needed for claims processing.
Managing healthcare provider accounts to achieve company strategies and goals.
Maintaining a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare.
Identifying shortfalls in healthcare provision and initiating improvement opportunities.

Provider Relations Representative Requirements:

Knowledge of EMR software, AdvanceMD and Eaglesoft.
A bachelor's degree in healthcare administration or equivalent.
A minimum of 2 years' experience in client services, provider relations, and claims processing.
Knowledge and understanding of claims processes and data capturing.
Proficiency in creating presentations, training documents, reports, and analytical graphs.
Proficiency in MS Outlook, Excel, and Word.
Ability to work independently.
Excellent verbal and written communication skills.
Good problem-solving skills.

Job Type: Full-time

Benefits:

Employee discount
Flexible schedule
Paid time off
Tuition reimbursement

Schedule:

8 hour shift
Day shift
Holidays
Monday to Friday
No weekends

Experience:

Call center: 1 year (Preferred)
Customer service: 1 year (Required)

Premium Health Care

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Provider Relations Specialist