Provider Relations Representative, Sr. jobs in Coachella, CA
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)
Recently Added Provider Relations Representative, Sr. 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, Sr. jobs found in Coachella, CA area
Customer Service Representative
- VINCI
-
Corona, CA
- ABOUT US ViaPlus is a global mobility company in the Intelligent Transportation Systems (ITS) market, specializing in re...
- 4/24/2024 12:00:00 AM
Customer Service Representative
- Group-A Engineering
-
Norco, CA
- Job Description Job Description Position: Customer Service Representative Reports to: Sales/ Brand Managers, General Man...
- 4/24/2024 12:00:00 AM
Call Center Customer Relationship Associate
- Myprovident
-
Riverside, CA
- ** Call Center Customer Relationship Associate** **Job Category****:** Retail Banking **Requisition Number****:** CALLC0...
- 4/24/2024 12:00:00 AM
Customer Service Representative
- firetrainingtoolbox.com
-
Riverside, CA
- **Customer Service Representative** ** Riverside, CA 3 months ago Be among the first 25 applicants** ** Welcome back** S...
- 4/24/2024 12:00:00 AM
Insurance Customer Service Representative
- Dean Mofidi Insurance Services
-
Palm Springs, CA
- Job Description Job Description We are seeking an Insurance Customer Service Representative to become a part of our orga...
- 4/24/2024 12:00:00 AM
Account Representative
- Square One Credit Services
-
Corona, CA
- Job Description Job Description We are growing !!!! We are looking for new representatives to join our new location.!!! ...
- 4/24/2024 12:00:00 AM
CUSTOMER SERVICE REPRESENTATIVE
- 3V Expansions
-
Murrieta, CA
- At 3V Expansions we specialize in taking our clients' product inquiries and turning them into profitable accounts. This ...
- 4/23/2024 12:00:00 AM
Customer Service Representative ( no vaccination required )
- PATH ARC
-
Coachella, CA
- The customer service representative will be responsible for answering client inquiries, provide product information, and...
- 4/22/2024 12:00:00 AM
About Coachella, California
Coachella (/koʊˈtʃɛlə/, /koʊ.əˈtʃɛlə/) is a city in Riverside County, California; it is the easternmost city in the region collectively known as the Coachella Valley (or the Palm Springs area). It is located 28 miles (45 km) east of Palm Springs, 80 miles (130 km) east of Riverside, and 130 miles (210 km) east of Los Angeles.
Known as the "City of Eternal Sunshine", Coachella is largely a rural and agricultural community in the desert and one of the state's fastest growing cities in the late 20th century. When it first incorporated back in 1946, it had 1,000 residents, but the population was 4...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$75,385 to $93,487
Coachella, California area prices
were up 3.0% from a year ago
were up 3.0% from a year ago
What does a Provider Relations Representative, Sr. do?
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