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)
SUMMARY OF JOB: Under the direction of the Assistant VP, the Provider Relations Representative is primarily responsible for the contracting and management of relationships with providers as assigned. This position will act as the main contact for contracting, contracting questions, education as well as a liaison between the provider and the health plan to present, promote and resolve clinical and administrative concerns of providers. This is a full-time, exempt position. Hours are generally 8:00 a.m. to 5:00 p.m. Monday through Friday.
** Hybrid schedule available after training and approval**
PRIMARY responsibilities:
EDUCATION, EXPERIENCE AND QUALIFICATIONS:
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