Provider Relations Representative jobs in the United States

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 Representative
  • Employers Health Nexus
  • Irving, TX FULL_TIME
  • ROLE AND RESPONSIBILITIES:

    The Provider Relations Representative possesses an integration of inter-personal, administrative, and specialized skill sets. This role assists in managing key provider relationships in all EHN Markets. The Provider Relations Representative will also assist in day-to-day network activity including but not limited to, provider roster management, provider education, provider onboarding, provider communications, communicating with clients, provider relations special projects and other duties as assigned. The main responsibilities include but are not limited to:

    • Assist in establishing and maintaining strong relationships with hospitals, physician groups, and ancillary providers that participate in the EHN network.
    • Support special projects, as assigned by Provider Relations Manager.
    • Review, track, and process new provider rosters in a timely manner.
    • Ensure health care groups are compliant with EHN provider manual and provide education around topics within the manual, plan guidelines, and clients.
    • Monitor, track and resolve inquiries received via provider relations email box, phone, or other communication.
    • Update and keep current tracking system for issue resolutions, special projects, rosters, etc.
    • Actively participate in provider meetings as needed or requested.
    • Work collaboratively with Network Operations team to resolve provider issues.
    • Proactively onboard and educate new and existing providers regarding network participation, EHN recognition, provider manual, clients that access the network, and other topics as needed.
    • Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.
    • Create and support provider communications such as welcome letters, Quick Reference Guides, Newsletters, etc.
    • Attend open enrollment sessions or in person provider meetings as requested.
    • Other duties and projects as needed and assigned by the Provider Relations Manager.

    QUALIFICATIONS AND EDUCATION REQUIREMENTS:

    • Bachelor’s Degree or equivalent Provider Relations experience
    • 3-5 years of provider relations experience
    • Demonstrate excellent presentation, verbal and written communication skills
    • Experience with client or provider relations, preferably in self-insured employer market
    • Proficiency with MS Excel, Word, and PowerPoint

    POSITION TYPE AND EXPECTED HOURS OF WORK:

    This is a hybrid, full-time, salaried position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m., with occasional after-hours or weekend duties.

    TRAVEL:

    This position may require 10% travel.

    Job Type: Full-time

    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Application Question(s):

    • Do you have experience with client or provider relations in the self-insured employer market?

    Education:

    • Bachelor's (Preferred)

    Experience:

    • provider relations: 3 years (Preferred)

    Work Location: Hybrid remote in Irving, TX 75038

  • 10 Days Ago

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Provider Relations Representative
  • UHS
  • LAS VEGAS, NV FULL_TIME
  • Responsibilities Job Summary: Provider Relations Representative is responsible for assisting in the full range of provider relations and service interactions for all lines of business within Prominenc...
  • 11 Days Ago

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Provider Relations Representative
  • American Health Plans LLC
  • Baton Rouge, LA FULL_TIME
  • American Health Plans manages institutional special needs plans (I-SNPs) in nursing homes in several states by sharing plan ownership with the facilities. Our roots in managed care run deep. We owned ...
  • 13 Days Ago

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Provider Relations Representative
  • tango
  • Phoenix, AZ FULL_TIME
  • We are in search of a detailed oriented self-starter to join our Provider Relations Team. The Provider Relations Representative will serve an important role overseeing our network of home health provi...
  • Just Posted

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Provider Relations Representative
  • EMI Health
  • Phoenix, AZ FULL_TIME
  • Founded by teachers in 1935, EMI Health has grown into a leading full-service health insurance organization serving employer groups across public and commercial sectors. With multiple recognitions as ...
  • Just Posted

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Internal Provider Relations Representative
  • Health Network One
  • Fort Lauderdale, FL FULL_TIME
  • Health Network One is the leader in managing specialty healthcare networks. Founded in 1999, we are a rapid growing, private equity-backed company that delivers cost savings to our health plan custome...
  • Just Posted

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Customer Relations Representative - State Farm Agent Team Member
  • Andres Barajas - State Farm Agent
  • Los Angeles, CA
  • Job Description Job Description Benefits: 401(k) 401(k) matching Bonus based on performance Flexible schedule Free unifo...
  • 5/20/2024 12:00:00 AM

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Community Relations Representative - Project Hire ($19.62-$24.38)
  • The Irvine Company, LLC
  • Irvine, CA
  • Assists the Community Manager and Assistant Manager with on-site operations of a single community, multiple communities,...
  • 5/19/2024 12:00:00 AM

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Customer Service Representatives LAFAYETTE, LA 105 ST LANDRY 70506
  • Pizza Hut Shop
  • Los Angeles, CA
  • 105 ST LANDRY **LAFAYETTE, LA 70506** **Customer Service Representatives** **Description:** What's on the menu: - DailyP...
  • 5/19/2024 12:00:00 AM

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Customer Service Representatives OPELOUSAS, LA 934 W CRESWELL LANE 70570
  • Pizza Hut Shop
  • Los Angeles, CA
  • 934 W CRESWELL LANE **OPELOUSAS, LA 70570** **Customer Service Representatives** **Description:** What's on the menu: - ...
  • 5/19/2024 12:00:00 AM

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Customer Relations Representative
  • PI Hollywood
  • Torrance, CA
  • We are a business and marketing firm that was founded almost a decade ago. We are looking to hire a Customer Relations R...
  • 5/17/2024 12:00:00 AM

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Patient Care Coordinator
  • UNIVERSITY MUSLIM MEDICAL ASSOCIATION, Inc.
  • Los Angeles, CA
  • Starting salaries are set in accordance with our compensation plan, which considers multiple individual and organization...
  • 5/16/2024 12:00:00 AM

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Customer Relations Representative - State Farm Agent Team Member
  • George Timuryan Insurance And Finan
  • Los Angeles, CA
  • Job Description Job Description We are seeking a Customer Relations Representative - State Farm Agent Team Member to joi...
  • 5/16/2024 12:00:00 AM

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Customer Relations Supervisor
  • PSA
  • Santa Ana, CA
  • Collectors is the leading creator of innovative technology that provides value-added services for collectors worldwide. ...
  • 5/16/2024 12:00:00 AM

Income Estimation for Provider Relations Representative jobs
$53,684 to $68,681