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Provider Relations Specialist

Randstad Professionals

This is a Full-time position in Lexington, KY posted November 23, 2021.

Do you have previous sales, provider relations, or contracting experience and a knowledge of healthcare?

Are you ambitious, a self-starter and willing to travel in the future up to 3 days per week working as a liaison between providers?

If so then this may be the position for you!

Our client is currently looking to fill a Provider Relations Specialist for their organization and are looking for that motivated individual to add to their rockstar team.

As a Provider Relations Specialist you would be performing duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues.

Perform training, orientation and coaching for performance improvement within physician practices.

If you feel you may be a good fit then please apply now so we can get to know you more!

Serve as primary contact for providers serving as a liaison between the provider and the health plan
Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on site and routing to the appropriate party for resolution
Receive and respond to external provider related issues
Initiate entry or change of provider related database information and oversee testing and completion of change request
Investigate, resolve and communicate provider claim issues and changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site education, EDI solicitation and problem solving
Perform provider orientations, including writing and updating orientation materials
Medical Software
Analytical Thinking
Written Communication
Verbal Communication
Medicare Compliance
Bachelors degree (preferred)
Years of experience: 3 years
Ability to travel
Job Type: Full-time

Dental insurance
Health insurance
Vision insurance
Monday to Friday
Work Location: On the road