Senior Provider Relations Representative

Compensation

: $80,020.00 - $144,170.00 /year *

Employment Type

: Full-Time

Industry

: Advertising/Marketing/Public Relations



Kelly Services is seeking a Senior Provider Relations Representative for an American health care insurance provider in Rancho Cordova, CA.Job Title: Senior Provider Relations Representative
Location: Rancho Cordova, CA (Work from home until further notice)
Job Type: Contract
Length: 6-Months
Est. Start Date: 6/15/2020
Hours: M-F, 8-5
Pay Rate: $30 - $35 per hour Day to Day Responsibilities of this Position and Description of Project: Will be the point of contact for a selected group of providers. Will be assigned a territory working with those providers on various inquiries (i.e. verifying demographic information, updating profiles, working with providers within line of business, etc.) JOB PROFILE SUMMARY:Position Purpose: Under direction, the Senior Provider Relations Representative maintains working relationships with provider organizations as assigned. This position is responsible for assuring accurate provider data, monitoring accounts receivable, and providing training, education, and information to providers. Acts as the Company liaison to providers, communicating Company s policies and procedures. May provide guidance or expertise to less experienced associates. Assesses provider-training needs. Assures compliance with contracts. Education/Experience: Bachelor s Degree in Health Care Administration or related field preferred. Minimum three years experience in provider relations, provider contracting; health plan operations or health care/medical office environment RESPONSIBILITIES: Assures compliance with respective contracts. Researches, analyzes and resolves claims, benefits, issues and authorization inquiries within delegated authority. Interprets Company s policies and procedures. Provides interpretation and clarification of benefits, eligibility, and access to care requirements. Escalates recurring or critical issues as appropriate to management. Assesses provider-training needs. Develops, implements, and conducts appropriate training programs and/or orientations for assigned provider staff. Monitors provider database of current data relating to provider and physician information. Ensures provider directories are accurate. Investigates compliance issues, identifies root cause, trains provider office staff on correct procedures, and provides written report of findings and recommendations. Meets on a regular basis in person or by telephone with assigned key provider groups to cultivate and strengthen relationships. Documents office visits and provider issues on shared drive log. Supports the retention of providers by participating in meetings, conducting research, and supporting provider credentialing. Assists management in tracking, trending and reporting on provider recruitment and retention. Provides support on special projects and performs other duties as needed or assigned. Roles that have done well: customer service in healthcare, contracting in health care (this group would be familiar working with providers and the various questions that come with it), claims Required Skills:

  • At least 2 years healthcare experience (not looking for someone who was in a providers office, just healthcare)
  • **Claims, call center, provider relations OK**
  • Great communication skills
  • Proficient in Word and Excel
  • 3 years experience in provider relations, provider contracting

Preferred Skills:

  • Credentialing Experience- or understand the concept of credentialing
  • Health plan operations/healthcare medical office environment

APPLY TODAY!**Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. If you have questions about the position, you may contact the recruiter recruiting for this position ...@kellyservices.com however, your resume should be uploaded via the SUBMIT RESUME button included within**



Why Kelly?


As a worker today, it s up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what s next is what we re all about. We know what s going on in the evolving world of work just ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.



About Kelly


At Kelly, we re always thinking about what s next and advising job seekers on new ways of working to reach their full potential. In fact, we re a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.
#KellyGTS



Job Requirements:
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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