Provider Relations Representative, Sr. jobs in San Bernardino, 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)

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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.
  • 1 Day 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...
  • 1 Day Ago

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Provider Relations Coordinator II
  • Desert Oasis Healthcare
  • Palm Springs, CA FULL_TIME
  • Assist Manager of Provider Relations and Desert Oasis Healthcare Administration by serving as a liaison between DOHC and primary care and specialist physicians and their staff, and contracted health p...
  • 2 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...
  • 18 Days Ago

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Np or pa
  • Provider Healthcare
  • Palm Springs, CA FULL_TIME
  • Job Type Full Time Schedule M-F 8-5 Patients Per Day 16-18 Work Location Outpatient clinic Job Description A Palm Springs, California based clinic is searching for a Nurse Practitioner or Physician As...
  • 1 Day Ago

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Inpatient Case Manager LVN/RN
  • HERITAGE PROVIDER NETWORK
  • San Bernardino, CA FULL_TIME
  • The Inpatient Case Manager is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified patients during an acute care episode. Assesses a...
  • 7 Days Ago

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0 Provider Relations Representative, Sr. jobs found in San Bernardino, CA area

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Customer Support Representative
  • DaVita Inc.
  • Colton, CA
  • **Customer Support Representative** Location 3000 Davita Way, Deland, FL 32724-2039, United States of America Category L...
  • 3/26/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Bloomington, CA
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/26/2024 12:00:00 AM

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Dispatcher/ Customer Service Representative
  • EFP Staffing
  • Fontana, CA
  • Job Description Job Description URGENTLY HIRING !! Great opportunity! ~ DISPATCHER/ CSR 3PL Third Party Logistics CSR is...
  • 3/26/2024 12:00:00 AM

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Preschool Services Coordinator for San Bernardino South West 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...
  • 3/25/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Colton, CA
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/25/2024 12:00:00 AM

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Patient Registration Rep
  • CommonSpirit 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. B...
  • 3/24/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Rialto, CA
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/24/2024 12:00:00 AM

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SALES & CUSTOMER SERVICE FIELD REP (TELCOM/INTERNET)
  • Onward
  • Fontana, CA
  • Job Description Job Description SALES & CUSTOMER SERVICE FIELD REP (TELCOM/INTERNET) Self-motivated, willing to go door ...
  • 3/24/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 59.6 square miles (154 km2), of which 59.2 square miles (153 km2) is land and 0.4 square miles (1.0 km2), or 0.74%, is water. The city lies in the San Bernardino foothills and the eastern portion of the San Bernardino Valley, roughly 60 miles (97 km) east of Los Angeles. Some major geographical features of the city include the San Bernardino Mountains and the San Bernardino National Forest, in which the city's northernmost neighborhood, Arrowhead Springs, is located; the Cajon Pass adjacent to the northwest border; City...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative, Sr. jobs
$76,019 to $94,273
San Bernardino, California area prices
were up 3.0% 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