Provider Relations Representative jobs in Texas
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
Provider Relations Rep I
- Driscoll Health
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Corpus Christi, TX
FULL_TIME
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Where compassion meets innovation and technology and our employees are family.Thank you for your interest in joining our team! Please review the job information below.General Purpose of Job:The Provider Relations Representative serves as the liaison between health care providers and Driscoll Health Plan; responsible for provider/facility initial orientation, ongoing education and problem resolution; performs office inspection/site surveys of new providers. Conducts visits with providers and their office staff on a routine basis to ensure open communication between health plan and providers. Also ensures provider demographic information is correct and up-to-date in assigned territory.Essential Duties and Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or administration as required.
- Maintains utmost level of confidentiality at all times.
- Adheres to hospital and Health Plan policies and procedures.
- Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
- Communicates the benefits of being a DHP provider.
- Provides timely education to providers and provider’s staff concerning contract requirements, DHP provider manual, policies and procedures, and claim submission guidelines.
- Provides timely education to providers and provider's staff on DHP electronic submission of claims, Electronic Funds Transfer processes, and web portal functions.
- Establish good working relationships with providers and provider offices in resolving issues to include being a trusted advocate for the provider.
- Establish a schedule of provider workshops to include specialty specific education.
- Assists providers with incentive programs, as applicable.
- Develop and implement a balanced scorecard metric.
- Assist the Contracting and Credentialing Departments as necessary.
- Document provider calls to include an Issues Log for monthly reporting.
- Develop and maintain a process for provider notification to include physician changes (moves, leaves practice, join practice, etc.).
- Communicates in both written and oral form with contracted professionals, individuals, on behalf of the physicians/Health Plan in order to obtain or relay information.
- Maintains up to date knowledge of physician contracts, claims and billing.
- Is detail oriented with exceptional presentation skills, ability to complete multiple projects and meet deadlines.
- Maintains excellent verbal and written communication skills, proficient computer skills helpful.
- Ability to provide prompt, courteous and excellent customer service to providers.
- Assists the CEO, CFO, Medical Director(s), Directors, or other staff as needed.
- Performs other duties as requested.
Education and/or Experience:- Licensure: Valid driver's license required.
- Two years’ experience in healthcare, medical provider or customer relations required.
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Minimum of 3 years’ experience in a Provider Relations role, preferably with a health plan or
provider network preferred. - At least a high school education with college degree preferred.
- 3 Days Ago
Provider Relations Coordinator - Days
- BHST
-
Beaumont, TX
FULL_TIME
- We are looking to add top talent to our Baptist Hospitals of Southeast Texas team. Join us in performing Sacred Work! Competitive benefits are offered including: Matched Retirement Plan Paid Time Off ...
- 5 Days Ago
Provider Relations Rep I
- 20 Driscoll Children's Health Plan
-
Corpus Christi, TX
FULL_TIME
- Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. General Purpose of Job: The Pro...
- 8 Days Ago
Provider Relations Specialist
- ProCare Advantage
-
Dallas, TX
FULL_TIME
- Job Summary:This position is a full-time hybrid role that is provider facing. This individual is responsible for the overall experience of providers, while also negotiating agreements with highly visi...
- Just Posted
Provider Relations Liaison
- CareNow
-
Coppell, TX
FULL_TIME
- Introduction Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our Provider Relations Liaison opening with CareNow today and find out what it tru...
- 10 Days Ago
Provider Relations Coordinator
- CCHP Cook Children's Health Plan
-
Fort Worth, TX
FULL_TIME
- Location: Calmont Operations Building Department: Network Mgmt Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Responsible for performing all physician, hospital and a...
- 11 Days Ago
Provider Relations Representative jobs at Popular Companies
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...
- 6/12/2024 12:00:00 AM
Provider Relations Representative - Towson, MD (Hybrid)
- Sheppard Pratt
-
Towson, MD
- Since our founding in 1853, Sheppard Pratt has been transforming care and leading the way, creating a mental health cont...
- 6/12/2024 12:00:00 AM
Provider Relations Representative - Baton Rouge, LA
- HMS
-
Baton Rouge, LA
- Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances...
- 6/12/2024 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 - 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
Donor Relations Representative
- Christus Health
-
Irving, TX
- Description Summary: Responsible for gift processing and donor relations including: responding to all donor inquiries, r...
- 6/10/2024 12:00:00 AM
Guest Relations Representative
- Six Flags Great Adventure
-
Jackson, NJ
- Assist Guests with questions, comments, concerns they may have about their experience while visiting Six Flags. Resolve ...
- 6/10/2024 12:00:00 AM
Provider Relations Representative
- Volunteers of America National Services
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- Volunteers of America National Services- PACE is seeking a Provider Relations Representative to service our Colorado Ser...
- 6/8/2024 12:00:00 AM
About Texas
Texas (/ˈtɛksəs/, locally /ˈtɛksɪz/; Spanish: Texas or Tejas Spanish pronunciation: [ˈtexas] (listen)) is the second largest state in the United States by both area and population. Geographically located in the South Central region of the country, Texas shares borders with the U.S. states of Louisiana to the east, Arkansas to the northeast, Oklahoma to the north, New Mexico to the west, and the Mexican states of Chihuahua, Coahuila, Nuevo León, and Tamaulipas to the southwest, while the Gulf of Mexico is to the southeast.
Houston is the most populous city in Texas and the fourth largest in the...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$52,676 to $67,394