PROVIDER RELATIONS REP I in Woburn, MA at Beacon Health Options

Date Posted: 5/21/2018

Job Snapshot

Job Description

ABOUT THE POSITION:

We are currently seeking dynamic Provider Relations Representatives to join our growing Provider Relations Team in Woburn, MA. The Provider Relations Representative provides internal support and follow-through in completion of the Provider Relations function. Supports the local provider relations’ staff, including Provider Relations Manager by conducting research, offering problem resolution and providing follow-up on a variety of provider issues that may arise.  Coordinates activities with other internal Beacon Health Options departments to provide optimal customer service to network providers and internal customers

DUTIES & RESPONSIBILITIES:

  1. Works closely with regional Network Operations team to ensure seamless customer service to providers.
  2. Answers practitioner/facility recruitment questions regarding Beacon Health Options policies and procedures.
  3. Provides follow up with practitioners and facilities for the return of completed credentialing and re-credentialing applications.
  4. Assists Provider Relations Managers with research to identify new providers for recruitment into the Beacon Health Options provider network.
  5. Assists Provider Relations Managers with report requests for network management purposes.\
  6. 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
  7. Provides assistance in compilation and mailing of provider recruitment mailings, general information, and educational materials to network practitioners as required.
  8. Works on special projects and performs other duties as assigned

Minimum Entry Level Qualifications

Education:   

  • Minimum of high school diploma; some college strongly preferred.

Years and Type of Relevant Work Experience:

  • State the minimum required years of relevant work experience and the level of that experience. For example: “Requires at least 10 years of progressively responsible professional experience in healthcare, with at least five (5) of those years in behavioral health.”)
  • At least three years of experience in customer service, claims auditing or provider relations, preferably in a behavioral health and/or managed care setting, is required.
  • Demonstrated ability to interact with mental health, substance abuse and employee assistance program providers.
  • Strong customer service orientation.
  • Good written and verbal communication skills
  • Ability to work in a team environment
  • Excellent problem solving skills, good follow-up abilities and willingness to be flexible and adaptable to changing priorities.
  • Ability to use PC-based word processing and spreadsheet applications, preferably the Microsoft Office suite of products.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled