PROVIDER RELATIONS REP I in Cypress, CA at Beacon Health Options

Date Posted: 5/23/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Provider Relations Representative I to join our team at our office in Cypress.  Provides internal support and follow-through in completion of the Provider Relations function. This position supports the local Director of Provider Relations by providing research, problem resolution and follow-up on a variety of provider issues that may arise.  The job also coordinates activities with other internal Beacon Health Options departments to provide optimal customer service to network providers and internal customers.

Position Responsibilities:

Commercial Contract

1.         Performs research and problem resolution on issues related to provider complaints, claims reported to have been processed incorrectly, coordinating credentialing paperwork, provider communications, or verification of information as requested

2.         Answers provider questions about Beacon, its contracts, policies and procedures

3.         Maintains a collaborative relationship with the operations, business personnel and provider community to incorporate process-related information into the training curriculum.

4.         Remain current on regulatory and company policy that impacts the provider network and related issues.

5.         Acting as a resource for providers on an ongoing basis to answer questions and resolved issues as they arise and act as a liaison between providers and other Beacon departments.

6.         Answers practitioner/facility recruitment questions regarding Beacon policies and procedures

7.         Identifying and soliciting providers based on network need for new and existing business.

Government Contract:

1.         Responding to provider calls on the Provider Services Line queue as well as emails, voicemails and faxes seeking assistance

2.         Acting as a resource for providers on an ongoing basis to answer questions and resolved issues as they arise and act as a liaison between providers and other Beacon departments.

3.         Answering provider questions about Beacon, its contracts, policies and procedures

4.         Responds to provider inquiries and requests for Beacon written materials

5.         Actively outreaches and trains providers to increase the rate of electronic transactions through training and education

6.         Identifies and resolves provider issues by researching causes and working with Beacon’s clinical, operations and IT teams

7.         Performs active outreach to ensure compliance with access and availability

8.         Works with providers and network operations to ensure provider data submission and accuracy

Position Requirements:

Education: High School diploma or GED required.  Bachelor’s degree preferred.

Licensure:  N/A

Relevant Work Experience:   Minimum 2 years’ experience in the HealthCare field.

Knowledge, Skills & Abilities:

•           Customer Service experience required; provider relations experience required.

•           Very strong verbal and written communication skills.

•           Must be detail oriented and able to work independently in a fast changing environment.

•           Strong understanding of managed care and health care operations.  Behavioral health experience preferred.

•           Must be able to work collaboratively with internal staff and external providers.

•           Must be well organized. Requires excellent communication and writing skills.

•           Have a professional demeanor and good public relations abilities.

•           Advanced level of PC skills required in Word and Excel.

TO APPLY

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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