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
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:
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**
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