Provider Relations AssistantBookmark This
Human Resource Group
5510 Nobel Dr
DescriptionThe Alliance® maintains a wide network of participating providers, located in three states. As provider relations assistant, you will be part of a team supporting The Alliance®’s efforts to develop and maintain this network for maximum benefit of members and their enrollees. The provider relations assistant position is essential to accurate loading of provider contracts and pricing data into claims and contract management system. Maintains healthcare provider registration data to assure availability for internal and external customers. Position serves as a liaison between provider relations and claims and customer service area, helping to resolve questions related to participation status of individual physicians and groups.
Responsibilities1. Supports Provider Contracting: (60%) Loads new contracts into claims and contracting database and updates existing records to reflect changes in the provider’s practice. Serves as a primary point of contact for provider’s business office and credentialing staff regarding registration of practitioners. Communicates important changes to others within the organization.
2. Works with Claims and Customer Service: (20%) Works closely with claims and customer service staff to investigate and resolve questions related to network participation status of providers. A proactive approach, including ability to identify potential problems before they occur and communicate those appropriately to contracting staff, is essential.
3. Departmental Projects :(20%) Works collaboratively with other staff for biennial directory verification mailing, prints and mails completed agreements to providers and helps with annual contract renewal process.
Requirements• Education/Experience - High school or equivalent education; A.A.S. is desired. Minimum of three years’ relevant office experience. Prior experience with health care business operations (e.g. insurance, credentialing, etc.) is preferred.
• Skills - The ideal candidate enjoys working as part of a team, has strong attention to detail and is comfortable making decisions that conform to our business processes. Business writing and communication skills are essential. Must be energetic, self-motivated, and comfortable in a fast-paced, deadline-oriented environment. Proficiency with MS Word and Excel required. Experience with Access is desired, but not required.