Provider Relations Representative II in Woburn, MA at Beacon Health Options

Date Posted: 2/20/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic Provider Relations Representative II to join our team at our office in Woburn, MA!  The Provider Relations Representative II will be a resource for the provider relations staff, providing support and assistance with any provider issues and departmental policies and procedures. Senior Provider Relations Representatives assist in managing Beacon’s behavioral health provider network, including administrative issue resolution, provider event planning and participation, network access monitoring, and recruitment.  Senior representatives work with clinical and operations departments to execute on provider relations strategy.

Position Responsibilities:

  • Identifies and resolves provider issues by researching causes and working with Beacon’s clinical, operations and IT teams
  • Assists Team Lead with escalated provider issues
  • Assists Team Lead with training staff members
  • Assists Manager and Team Lead with quality assurance measures
  • Assists in the identification of service level gaps and works with Manager of Provider Relations and Contracts Managers to address recruitment opportunities
  • Actively outreaches and trains providers to increase the rate of electronic transactions through training and education
  • Responding to provider calls on the Provider Services Line queue as well as emails, voicemails and faxes seeking assistance
  • Works with Manager of Provider Relations to plan and present provider events, including Provider Advisory Councils and Provider Appreciation Breakfasts in all markets
  • Performs active outreach to ensure compliance with access and availability
  • Works with providers and network operations to ensure provider data submission and accuracy
  • Builds collaborative relationships with client health plan counterparts
  • Assists with network reporting activities
  • Processes and responds to providers interested in joining Beacon’s network
  • Participates in the coordination and processing of Network department mailings
  • Responds to provider inquiries and requests for Beacon written materials
  • Scheduling, leading and reporting on provider site visits
  • Other duties and projects as assigned in line with Department and company needs.

Position Requirements:

  • Education: AAS degree required, B.S. degree preferred
  • Relevant Work Experience: 2-3 years Customer Service experience with 2-3 years Claims experience required
  • Knowledge, Skills & Abilities:
    • Previous data entry 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 healthcare operations

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