Regulatory Relations Specialist jobs in Baton Rouge, LA

Roles & Responsibilities

The Provider Relations Specialist is an integral member of the Verity Network and operations development teams. The person selected for this role is responsible to deliver industry leading service to physicians, providers, practice managers, and/or ancillaries within the provider networks. Additionally, this person will be responsible for educating providers about Verity operations and solving escalated problems.

Responsibilities include but are not limited to:

• Develops and maintains strong relationships with contracted medical providers.
• Manages and reviews all provider issues including root cause analysis and resolution, communicating resolution plans to the providers and ensuring follow through on such resolutions to the problem.
• Resolves and manages incoming provider claim repricing and review requests; Coordinates claims resolution with the payers.
• Responsible for the submission of provider adds/terms/changes resulting from service and claim issues.
• Works with internal customer service/claims and external teams to improve overall provider service experience and workflows.
• Works with operations to ensure all provider data is populating correctly on the website.
• Attend and represent Verity at employer Benefit Fairs and expos.
• Assist with network and contracting related projects, as needed.
• Develops strong working relationships with internal staff.
• Exemplifies what it means to be a high-performance service excellence organization.

Qualifications

• Bachelor’s degree preferred with 2 years in a similar role or other customer facing high demand service organization; alternatively; Candidates with 3 years in a similar role will be considered
• Professional record showing advancing responsibility in providing service to customers ispreferred

Skills

• Problem solver
• Strong analytical skills
• Ability to use Microsoft office products and quickly learn new PC software.
• Knowledge of physician CPT coding is needed
• Strong knowledge of the managed care/healthcare industry
• Strong written and verbal communication skills and some experience with formal presentations
• Critical thinker willing to challenge the status quo offering new solutions to problems.
• Team player with proven ability to develop strong working relationships within a complex organization.
• Organize, prioritize, coordinate and manage a large workload with solid results.
• Motivated self-starter; delivering on required job demands.
• Maintain confidentiality information and comply with Health Insurance Portability and Accountability Act (HIPPA).
• Comply with all company policies.
• Travel approximately 10% on average.
• Hours: Full time, in the Baton Rouge office (36-40 hours per week).

Company Information

Verity HealtNet is committed to revolutionizing the way healthcare is delivered by making a positive impact on the lives of patients and providers alike. We believe in a diverse, inclusive workplace and are always looking for creative, analytical, innovative, and passionate thinkers and doers who are driven to learn as well as succeed. Choosing to work for Verity HealthNet means being part of a team that values collaboration, candor, and integrity.

Verity HealthNet is a company that fosters a supportive work environment, where employees are encouraged to contribute their unique perspectives and ideas and have the opportunity to be at the forefront of groundbreaking healthcare solutions. By investing in our workforce, Verity empowers its employees’ growth and development by offering competitive hourly/salary wages and career progression. We help support our employees’ career initiatives, both professionally and personally, while maintaining a healthy work/life balance.

A career at Verity HealthNet offers an exceptional opportunity to be part of a forward-thinking organization that is transforming healthcare. With a supportive work environment, a commitment to innovation, a focus on employee growth and culture, and a dedication to improving healthcare outcomes, Verity HealthNet is an ideal choice for individuals passionate about making a meaningful difference in the healthcare industry, leading to a tangible impact on the lives of patients and their communities.