Provider Relations Representative jobs in Rialto, 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
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.
- 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
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
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
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
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
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 Rialto, CA area
Customer Service Representative
- E-Z Mix Inc
-
Rialto, CA
- Job Description Job Description Interested Candidates will need to complete an application onsite from Monday through Fr...
- 4/24/2024 12:00:00 AM
Customer Relations Representative - State Farm Agent Team Member
- Ngoc Phung - State Farm Agent
-
Santa Ana, CA
- Position Overview: Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to t...
- 4/24/2024 12:00:00 AM
Customer Service Representative
- Walmart
-
San Bernardino, CA
- **Job Title: Customer Service Representative (Walmart)** **Job Summary:** As a Customer Service Representative at Walmar...
- 4/24/2024 12:00:00 AM
Patient Registration Rep
- Dignity Health
-
San Bernardino, CA
- **Overview** Founded as a faith-based hospital in 1931 by the Sisters of Charity of the Incarnate Word Dignity Health St...
- 4/24/2024 12:00:00 AM
Preschool Services Coordinator for San Bernardino North East Unit
- St. Elizabeth's Medical Center
-
San Bernardino, CA
- SUMMARY: Under the direct supervision of the Program Manager is responsible for coordinating the services and support av...
- 4/23/2024 12:00:00 AM
Client Representative
- Summit Strive Consulting
-
San Bernardino, CA
- Job Description Job Description Job Title: Client Representative Company Overview: Join our passionate team dedicated to...
- 4/23/2024 12:00:00 AM
Customer Relations Representative
- MaxLite
-
Anaheim, CA
- Customer Relations Representative Customer Relations Job Type Full-time Description **Customer Relations Representative*...
- 4/21/2024 12:00:00 AM
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
About Rialto, California
Rialto is a city in San Bernardino County, California, United States. The population was 99,171 with the 2010 Census.
Rialto is home to four major regional distribution centers: Staples Inc., which serves stores across the entire West Coast of the United States, Toys "R" Us, Under Armour and Target in the northern region of the city, in the Las Colinas community. One of the United States' largest fireworks companies, Pyro Spectaculars, is also headquartered in Rialto.
Rialto is located at 34°6′41″N 117°22′57″W / 34.11139°N 117.38250°W / 34.11139; -117.38250 (34.111360, −117.382403).
Accordi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$56,559 to $72,359
Rialto, California area prices
were up 3.0% from a year ago
were up 3.0% from a year ago