Provider Relations Representative, Sr. jobs in Charlotte, NC

Provider Relations Representative, Sr. 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. May provide guidance or expertise to less experienced representatives. Being a Provider Relations Representative, Sr. typically requires a bachelor's degree. Typically reports to a supervisor or manager. The Provider Relations Representative, Sr. gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Relations Representative, Sr. typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Provider Relations Analyst Europe
  • The Cigna Group
  • Charlotte, NC OTHER,FULL_TIME
  • Job summary

    As a Provider Relations Specialist you will be part of the Provider Services Organization, being responsible to manage the relationship with Health Care Providers of European network. You will work very closely with peers and stakeholders strategically positioned across the globe.

    Key to the role will be the end-to-end journey, managing the partnership with health provider accounts, such as hospitals and clinics and support their journey from the on-boarding, supporting on the daily / monthly interactions with Cigna, educate them to navigate Cigna operating model, monitoring their performance, and driving engagement initiatives.

    Your role includes:

    • Accountable to enable an effective and efficient collaboration with health providers in order to deliver a best in class customer experience through the partnership with our providers.

    • Secure a smooth on-boarding and day-to-day operational maintenance of provider relationships.

    • Conducts all aspects of health care professional education for existing and newly contracted health care professionals as pertinent in the region to remove potential roadblocks preventing a successful partnership, including but not limited to:

      • Onboarding and overview of member identification and eligibility process

      • Claims submission.

      • Cigna operating model

      • Training in legacy portal and on-board of selected providers into new provider portal

      • Communication channels

    • Manage the ongoing relationship and handling day-to-day operations directly with health care providers, including the follow up, negotiation and resolution of potential complaints, escalations, suspensions or threats.

    • Responsible to enable an effective and efficient collaboration with health providers through monitoring and analyzing the Operations KPIs, the results of the reconciliation of the accounts and others in order to provide a comprehensive support on their interpretation and assurance of further follow up if needed.

    • Strive for continuous service improvement via analyses of root causes and proactive implementation of initiatives driven by outcome obtained  through data and feedback gathered through reconciliation results, complaints or other sources, continuous service delivery improvement through BAU collaboration with different teams;

    • Active communication and prompt follow up combined with regular meetings with your dedicated health care providers.

    • Consolidated feedback to PS management team

    • Continuous improvement and maintenance of provider communications channels taking into consideration the local habits and practices.

    • Proactive education to providers on the way to work with Cigna, including the roll out of new processes.

    • Provider visits as applicable

    YOUR PROFILE

    • If internal 1 years of Cigna experience, relevant experience in other functions/companies, and a strong performance track record.

    • If external, at least 2 years of experience in Operations, Data analysis, Marketing/Communications or Relationship Management, with operational and customer/provider-facing experience profile.

    • Proficient in English and other European language (s) such as German/ French/ Portuguese/ Italian; additional language is a plus.

    • Strong analytical and problem-solving skills.

    • International mind-set able to work remotely with colleagues, partners and providers across the globe.

    • Striving for excellent service to our members, clients and providers is part of your DNA.

    • Strong can-do attitude, and high qualification in relationship management, including a broad understanding of multicultural behaviors.

    • Action-orientated problem-solving attitude

    • Excellent organization, planning and prioritization skills to meet deadlines.

    • Experience in complaint management - with a proven track record in improving customer service standards.

    • Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.

    • Accountability – to assume ownership for achieving personal results and to contribute for collective team goals.

    • Excellent communication skills – verbal, written and presentation. 

    • Be a positive role model and be able to work independently and in conjunction with co-workers of all levels.

    • Experience interpreting data, drafting reports.

    • Strong practical knowledge of MS Office applications, including Excel.

    • Availability to travel 10% of your time (estimation)

     

    About Cigna Healthcare

    Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

    Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

    If you require reasonable accommodation in completing the online application process, please email: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.

  • 13 Days Ago

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North Carolina - Regional Manager of Provider Relations
  • KPH Healthcare Services
  • Matthews, NC FULL_TIME
  • Overview Travel: Daily travel required. Limited overnight travel required. Attendance at various business and management conferences may be required. Scope of Responsibilities: Responsible for sales i...
  • 19 Days Ago

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Payor Relations Representative
  • Providence Anesthesiology Associates PA
  • Charlotte, NC FULL_TIME
  • DescriptionAbout Providence Anesthesiology AssociatesHeadquartered in Charlotte, North Carolina, Providence Anesthesiology Associates (PAA) is an independent physician owned practice compromised of ov...
  • 5 Days Ago

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Customer Relations Representative
  • SAERTEX USA LLC
  • Huntersville, NC FULL_TIME
  • Job Title: Customer Service Representative Location: STX I, Huntersville, NC Reports To: Customer Relations Manager SCOPE OF POSITION: The Customer Service Representative is responsible for profession...
  • 1 Month Ago

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Sr Sales Representative
  • honeywell
  • Charlotte, NC FULL_TIME
  • Healthcare Strategic Account Manager Job Description The future is what you make it. When you join Honeywell, you become a member of our global team of thinkers, innovators, dreamers, and doers who ma...
  • Just Posted

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Sr. Land Representative - North Carolina
  • TRC Companies, Inc.
  • Charlotte, NC FULL_TIME
  • About Us Groundbreaker. Game changer. Pioneer. TRC has long set the bar for clients who require more than just engineering, combining science with the latest technology to devise innovative solutions ...
  • 23 Days Ago

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0 Provider Relations Representative, Sr. jobs found in Charlotte, NC area

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SIGNING AGENT
  • Costner Law Office Pllc
  • Charlotte, NC
  • Job Description Job Description Signing Agent Charlotte, NC (Ballantyne area) Description Charlotte based law firm is se...
  • 3/28/2024 12:00:00 AM

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Customer Service Representative
  • Falcone Crawl Space & Structural Repair
  • Charlotte, NC
  • Job Description Job Description We are a five-time NC best employer to work for, looking for a production/customer servi...
  • 3/28/2024 12:00:00 AM

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CSR, SBO Customer Service (Full-Time Remote)
  • North American Credit Services
  • Charlotte, NC
  • Job Description Job Description We are growing! MedSrv is a market leader in the healthcare receivables industry, servin...
  • 3/28/2024 12:00:00 AM

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Convention Center Technician/ Customer Service Representative - Part Time
  • Smart City Networks, Limited Partnership
  • Charlotte, NC
  • Job Description Job Description Responsibilities and essential job functions include but are not limited to the followin...
  • 3/28/2024 12:00:00 AM

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Sales Manager
  • Hampton Inn & Suites Charlotte
  • Charlotte, NC
  • Job Description Job Description Sales Manager Department – Sales Reports to – General Manager What’s the job? As Sales M...
  • 3/27/2024 12:00:00 AM

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Guest Relations Representative
  • Modern Salon & Spa
  • Charlotte, NC
  • Job Description Job Description POSITION SUMMARY: Responsible for answering and transferring incoming calls, including c...
  • 3/27/2024 12:00:00 AM

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Customer Relations Representative
  • Saertex USA Llc
  • Huntersville, NC
  • Job Title: Customer Service Representative Location: On-Site / Huntersville, NC Reports To: Customer Relations Manager *...
  • 3/27/2024 12:00:00 AM

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Payor Relations Representative
  • Providence Anesthesiology Associates PA
  • Charlotte, NC
  • Job Type Full-time Description About Providence Anesthesiology Associates Headquartered in Charlotte, North Carolina, Pr...
  • 3/25/2024 12:00:00 AM

Charlotte (/ˈʃɑːrlət/) is the most populous city in the U.S. state of North Carolina. Located in the Piedmont, it is the county seat of Mecklenburg County. In 2017, the U.S. Census Bureau estimated the population was 859,035, making it the 17th-most populous city in the United States. The Charlotte metropolitan area's population ranks 22nd in the U.S., and had a 2016 population of 2,474,314. The Charlotte metropolitan area is part of a sixteen-county market region or combined statistical area with a 2016 census-estimated population of 2,632,249. Between 2004 and 2014, Charlotte was ranked as...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$69,707 to $86,445
Charlotte, North Carolina area prices
were up 1.5% from a year ago

Provider Relations Representative, Sr. in Kingsport, TN
A job as a Provider Relations Representative falls under the broader career category of Business Operations Specialists, All Other.
February 18, 2020
Provider Relations Representative, Sr. in Sioux City, IA
The PR Rep serves as a liaison between contracted payers, providers and ancillary providers to promote superior customer service and seamless programs.
February 16, 2020
Provides telephonic provider education to new providers.
February 14, 2020
Provider Relations Representative, Sr. in Buffalo, NY
This position provides on-going communication, in-service, orientation, and direction to these contracted provider offices.
February 03, 2020