Provider Relations Representative jobs in Kansas
Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Recently Added Provider Relations Representative jobs
Dental Provider Relations Field Representative - Mississippi
- Avēsis
-
Home, KS
FULL_TIME
-
Join us for an exciting career with the leading provider of supplemental benefits!
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
The Provider Relations Field Representative is tasked as part of the Provider Relations Department to be the liaison between Avesis and the participating provider network. Our chosen candidate will be responsible for coordinating efforts to build and nurture positive relationships with the Avesis dental provider community to include but not limited to best-in-class provider education and training, issues research and projects. The Provider Relations Field Representative role is a hybrid position which will include remote office and field travel to support provider network relationships and initiatives.- Provider Operations encompasses several diverse provider administrative duties to improve the Avesis provider experience including direct provider engagement and training with the goal of resolution of issues.
- Conducts provider outreach via in-person/video/phone or email by providing training, orientation, and coaching for performance improvement within provider practices. Provide guidance through education to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools.
- Conduct monthly and/or quarterly meetings with provider groups documenting discussions, issues, attendees, action items, researching claims or prior authorization issues on site and routing to the appropriate party for resolution.
- Owns and manages relationship and performance of assigned provider groups. Serves as the primary point of contact for assigned providers.
- Communicate and shares provider claims and directory reporting both internally and externally and additional reporting as necessary.
- Complete provider orientation via phone, email, in-person and/or virtually for all applicable product lines to train, resolve issues, and educate staff/providers.
- Perform onsite facility reviews, when applicable and conduct quarterly face-to-face visits within the assigned territory and/or market. Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects.
- Educate providers regarding state program, group policies, and/or health plan policies and procedures and state/federal regulation for compliance requirements. Investigate and respond to complex provider related issues and initiate change of provider demographic related database information.
- Responds to general provider contract inquiries, provider education and non-routine claim issues.
- Attend work-related events/conferences while representing the organization and brand in a professional manner.
- Coaches, mentors, and develops junior team members as applicable.
- Demonstrating a collaborative approach to problems–solving by successfully working with and effectively communicating with other areas (account management, utilization management, provider services).
- Other duties as assigned.
- Local travel throughout the state of Mississippi (with a focus on Jackson and Biloxi) is required - see travel guidelines below.
- High School Diploma or equivalent required Bachelor’s degree preferred.
- 1 to 2 years of Dental office administration experience required.
- 1 to 2 years of health insurance claims, as well as ability to analyze data to resolve provider claim issues.
- Comprehension of Medical/Dental Terminology experience required.
- Dental Assisting National Board (DANB) certified or Certified dental assistance (CDA) preferred.
- Minimum 1 year experience with provider credentialing and contracting process preferred.
- Knowledge of health plan operations preferred
- Knowledge of provider/health plan contracts/agreements highly desired
- Microsoft applications and other windows-based applications to include an intermediate level in Microsoft Excel and databases. Knowledge of and intermediate ability to use various computer programs such as Microsoft Office including spreadsheets, data bases, word processing and presentation software and programs/systems utilized in data analysis.
FLSA Status: Salary/Exempt
Salary Range: $46,080 - $61,440
How To Stay Safe
Avesis is aware of fraudulent activity by individuals falsely representing themselves as Avesis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to make purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company.
Avesis would never make such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during process. Our recruitment process takes place by phone and via trusted business communication platform (i.e., Zoom, Webex, Microsoft Teams, etc.). Any emails from Avesis recruiters will come from a verified email address ending in @Avesis.com. We urge all applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reach out to ITsupport@Avesis.com.
To learn more about protecting yourself from fraudulent activity, please refer to this article link (https://consumer.ftc.gov/articles/how-avoid-scam). If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/) with the Federal Trade Commission. Avesis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity.
We Offer- Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
- Competitive compensation package.
- Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
- Life and disability insurance.
- A great 401(k) with company match.
- Tuition assistance, paid parental leave and backup family care.
- Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
- Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
- Employee Resource Groups that advocate for inclusion and diversity in all that we do.
- Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.
At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You! - 11 Days Ago
Manager, Provider Relations
- Centene Management Company LLC
-
Remote, KS
FULL_TIME
- You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll hav...
- 9 Days Ago
Manager, Provider Relations
- Sunflower Health Plan
-
UNKNOWN, KS
FULL_TIME
- You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll hav...
- 18 Days Ago
T-Mobile Sales Representative
- T-Mobile Sales Representative
-
Manhattan, KS
PART_TIME,FULL_TIME
- T-Mobile Premium Retailer – Wireless Vision Do the hottest new tech trends excite you? Do you naturally make connections with people everywhere you go? Then a Mobile Expert role with Wireless Vision w...
- 26 Days Ago
Part Time T-Mobile Sales Representative
- T-Mobile Sales Representative
-
Pittsburg, KS
PART_TIME
- T-Mobile Premium Retailer – Wireless Vision Do the hottest new tech trends excite you? Do you naturally make connections with people everywhere you go? Then a Mobile Expert role with Wireless Vision w...
- 24 Days Ago
Network Relations Consultant (LTSS Provider Rep)
- Elevance Health
-
Kansas, KS
FULL_TIME
- Description Network Relations Consultant, LTSS Provider Representative Location: Kansas. This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of on...
- 1 Day Ago
Provider Relations Representative jobs at Popular Companies
Provider Relations Representative
- American Health Partners
-
Sparta, GA
- American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
- 6/11/2024 12:00:00 AM
Provider Relations Representative (Bilingual Chinese)
- Clever Care Health Plan
-
Arcadia, CA
- Wage Range: $24.00/hr - $28.00/hr Job Summary This position serves as an integral member of the Provider Relations and C...
- 6/11/2024 12:00:00 AM
Provider Relations Representative
- American Health Plans
-
Milledgeville, GA
- American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
- 6/10/2024 12:00:00 AM
Provider Relations Representative
- Arkos Health
-
Gilbert, AZ
- This is an in-office position with minimal travel in the field. Our Organization: Welcome to Arkos Health! We are a valu...
- 6/10/2024 12:00:00 AM
Provider Relations Representative - Oxnard, CA
- UnitedHealth Group
-
Oxnard, CA
- Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
- 6/10/2024 12:00:00 AM
Provider Relations Representative
- Phoebe Physicians
-
Albany, GA
- Description JOB SUMMARY Serves as a liaison between PHP providers and the organization to meet provider network services...
- 6/8/2024 12:00:00 AM
Provider Relations Representative
- Volunteers of America National Services
-
Eden Prairie, MN
- Volunteers of America National Services- PACE is seeking a Provider Relations Representative to service our Colorado Ser...
- 6/8/2024 12:00:00 AM
Provider Relations Representative
- American Health Plans
-
Boise, ID
- American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
- 6/7/2024 12:00:00 AM
About Kansas
Kansas /ˈkænzəs/ (listen) is a U.S. state in the Midwestern United States. Its capital is Topeka and its largest city is Wichita, with its most populated county being Johnson County. Kansas is bordered by Nebraska on the north; Missouri on the east; Oklahoma on the south; and Colorado on the west. Kansas is named after the Kansa Native American tribe, which inhabited the area. The tribe's name (natively kką:ze) is often said to mean "people of the (south) wind" although this was probably not the term's original meaning. For thousands of years, what is now Kansas was home to numerous and divers...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$51,224 to $65,536