Provider Relations Representative

🔥 3 minutes ago

🎸 Tennessee, Texas – Remote

🎸 Tennessee – Remote 🤠 Texas – Remote

💵 $55.9k - $123.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

📋 Description

• Responsible for the contracting, credentialing, and maintenance of professional provider data to support marketing, membership and network contracting across all lines of business. • Building relations with the provider community. • Promoting high quality initiatives to support data integrity. • Accepting ownership and leading highly specialized operational and customer support duties that require independent initiative. • Participating in internal provider meetings and work groups. • Researching problems related to provider credentialing, data and network participation. • Providing training and education to all Blue Cross contracted providers including hospitals, physicians, and other allied professional providers.

🎯 Requirements

• Bachelor’s Degree and three (3) years of work experience in managed care OR a minimum of five (5) years work experience in a managed care environment. • Two (2) years of healthcare administration experience in clinical and financial settings, with direct provider communication experience. • Effective interpersonal, analytical, presentation and communication skills. • Knowledge of the healthcare industry, healthcare systems and payer/provider dynamics. • Ability and willingness to travel within assigned areas for responsibility, including overnight stays. • Strong comprehension of contracts, applications, and products. • Understanding of provider reimbursement methodologies and claims. • Working knowledge of claims processing systems. • Effective organizational and planning skills with the ability to take initiative and work independently. • Demonstrated ability to meet deadlines and work well under pressure. • Clear and concise interpersonal, verbal and written communication skills. • Collaboration skills resulting in business/process improvements/changes. • PC proficiency and skills to include Word, Excel, PowerPoint, etc. • Strong facilitation, presentation and analytical skills.

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement