Provider Relations Representative jobs in Apple Valley, CA

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

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Provider Relations Representative
  • Desert Oasis Healthcare
  • Palm Springs, CA FULL_TIME
  • The Provider Relations Representative assists the Manger of Provider Relations and Desert Oasis Healthcare Administration by serving as a liaison between DOHC and Primary Care, Specialist Provider, their staff, and contracted health plans. The Provider Relations Representative provides in-office administrative support for the Provider Relations department through collaboration, customer service, attention to detail and remaining abreast on the health care delivery system.
    • Acts as the primary resource for the provider network by maintaining regular schedule of physician office visits to ensure open lines of communication between DOHC and the provider network. Assuring all providers receive timely and accurate information regarding organization initiatives, services, programs, policies and procedures, and quality measurements.
    • Supports Primary Care Providers, Specialty Providers, Ancillary Providers, and health plans with the resolution of administrative issues and concerns in a timely fashion.
    • Market DOHC programs and services to providers and their staffs regularly to assist in developing a value based practice for DOHC members.
    • Communicate and interact effectively with PCPs, Specialists and other contracted vendors/services through coordination, attendance at regular Office Manager meetings.
    • Collaborate with Credentialing Department by obtaining and reviewing appropriate documents for initial credentialing requests, ensure documents were received by applicant, received documents back in the proper format, acquiring any additional documents needed and submitting to VP of Network Administration for review.
    • Establish DOHC brand recognition through regularly attending and participating in employer group events.
    • Manages qHMO, EZNet and other DOHC systems user accessibility for the provider network.
    • Coordinate the HCC program within the participating provider network by assisting with ICD and CPT coding for coding / billing as assigned.
    • Review and report statistical data for potential chart review / audit of participating provider network.
    • Maintain a structured process for quality of audits, tracking and trending including tracking provider network progress on HCC Concurrent program, and coordinate with HCC Department on further trainings.
    • Maintains detailed and accurate provider contact notes.
    • Performs other duties as assigned.
    (11278)

    • Associates degree in Business, Marketing or Healthcare Administration or closely related field; Bachelor’s Degree in Business, Health Care Administration, Marketing, Public Health, Psychology or closely related field, preferred.
    • Three years of Customer Service, Healthcare, or Marketing experience. Managed care and IPA/Medical experience, preferred.
    • Proficient knowledge of computers and Microsoft Office Suite programs (Excel, Word, Power Point, etc.)
    • Working knowledge of EZ-Cap or NextGen, preferred.
    • Knowledge of CPT, ICD, HCPCS, HCC coding.
    • Ability to communicate effectively with individuals within all levels of the organization, patients, providers, vendors and others.
    • Ability to manage time effectively and prioritize tasks to meet established deadlines.
    • Able to attend Provider Network meetings during regular business hours, evenings and/or weekends.
    • Ability to work independently with minimal supervision.
    • Current California driver’s license and proof of auto insurance.
    • At the discretion of DOHC/FHC management, this position has the potential to be a full or hybrid telecommuting position.
  • 28 Days Ago
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Provider Relations Representative - Other Administrative Services
  • Providence
  • Apple Valley, CA OTHER
  • DescriptionUnder the supervision of the Director, the Provider Relations Representative functions as a liaison among the contracted physician/specialist offices and St. Joseph Heritage Healthcare. Thi...
  • 28 Days Ago
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Client Relations Representative
  • Creative Perspective
  • Highland, CA FULL_TIME
  • Creative Perspectives Management partners with businesses to establish brands and improve loyalty with competent campaigns. We are dedicated to going the extra mile to ensure that our marketing strate...
  • 1 Month Ago
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Provider Patient Concierge Representative
  • RadNet
  • Victorville, CA FULL_TIME
  • Overview: Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Radiology Forward. With dynamic cross-training and advancement opportunities in...
  • Just Posted
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Provider Patient Concierge Representative
  • Radnet Management, Inc.
  • Victorville, CA FULL_TIME
  • ResponsibilitiesArtificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Leading Radiology Forward. With dynamic cross-training and advancement op...
  • 5 Days Ago
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RN Visiting Nurse
  • TRIUNE HOME HEALTH PROVIDER
  • Hesperia, CA FULL_TIME
  • We are a family owned home health care provider. We have an open position for home health Registered Nurses to visit home bound patients based on doctors orders. The professional nurse builds from the...
  • 7 Days Ago
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0 Provider Relations Representative jobs found in Apple Valley, CA area

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Customer Service Representative
  • Walmart
  • Victorville, CA
  • **Job Title: Customer Service Representative (Walmart)** **Job Summary:** As a Customer Service Representative at Walmar...
  • 4/24/2024 12:00:00 AM
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S
Patient Service Technician - Delivery Driver
  • Super Care Health
  • Victorville, CA
  • **Patient Service Technician - Delivery Driver** * Victorville, CA * Full-Time * Operations * Patient Service Technician...
  • 4/23/2024 12:00:00 AM
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Customer Service Representative ( no vaccination required )
  • PATH ARC
  • Apple Valley, CA
  • The customer service representative will be responsible for answering client inquiries, provide product information, and...
  • 4/22/2024 12:00:00 AM
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Customer Service Representative ( no vaccination required )
  • PATH ARC
  • Victorville, CA
  • The customer service representative will be responsible for answering client inquiries, provide product information, and...
  • 4/22/2024 12:00:00 AM
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Community Service Specialist (Community Service Specialist I), Parking Administration
  • California State University
  • San Bernardino, CA
  • Community Service Specialist (Community Service Specialist I), Parking Administration Job no: 538478 Work type: Staff Lo...
  • 4/22/2024 12:00:00 AM
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A
Customer Service Representative
  • American Pluming Diagnostics And Re
  • Hesperia, CA
  • Job Description Job Description We are seeking a Customer Service Representative to join our team! You will be responsib...
  • 4/21/2024 12:00:00 AM
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FT Customer Service Representative - Work From Home>
  • ARIVE
  • Hesperia, CA
  • [Call Center / Remote] Anywhere in U.S. / Up to $50K per year / Medical, Dental and Vision / 401k match / PTO - As a Cus...
  • 4/20/2024 12:00:00 AM
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Afternoon Member Services Representative - Part Time - S Riverside, Rialto
  • Taymax Group
  • Rialto, CA
  • Rialto S Riverside 585 S Riverside Ave, Rialto, CA 92376, United States of America Pay : $16.00 - $16.50 It's fun to wor...
  • 4/20/2024 12:00:00 AM
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About Apple Valley, California

Apple Valley is located at 34°31′N 117°13′W / 34.517°N 117.217°W / 34.517; -117.217 (34.5115, -117.2120). Apple Valley is located at the southern edge of the Mojave Desert. It is bordered by the cities of Victorville on the west and Hesperia on the southwest sides, with the Census-Designated Place of Lucerne Valley a distance to the east and the city of Barstow about 30 miles to the north. Apple Valley, along with Victorville, Hesperia, Adelanto and immediate surrounding areas, are commonly known as the Victor Valley. The primary thoroughfare through Apple Valley is State Route 18, which wa...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$56,345 to $72,084
Apple Valley, California area prices
were up 3.0% from a year ago
View detail