Provider Relations Specialist
City of Lincoln, Forge Spring Village, PA, United States
Provider Relations Specialist performs a full range of activities related to the Provider Relations department. Assists Provider Relations Department management with contracting, credentialing, educating and maintenance of Hamaspiks provider network. Researches and responds to provider inquiries timely.
Essential Responsibilities
Answer provider inquiries through telephonic and email contact.
Onboard and orient new providers through follow-up telephone calls, webinars, etc.
Utilizing established templates, draft contracts for new providers and amendments for existing providers.
Conduct Access and Availability surveys.
Assist in creating and maintaining reports pertaining to providers.
Obtain single case agreements (SCAs) from non-contracted providers, maintain log, obtain countersignature, notify providers and appropriate internal departments.
Establish and update provider records on company systems, including Salesforce.com and QNXT.
Participate in Provider Relations projects and assigned tasks as necessary.
Specific Knowledge, Skills, and Abilities
Strong organizational skills.
Detail oriented with ability to shift gears and prioritize multiple demands.
Ability to interact effectively with a variety of people (such as physicians, medical office staff, administrative staff of nursing homes and home care agencies, etc.) as well as colleagues.
Good written and verbal communication skills
Ability to work independently but recognize when to elevate or seek help.
Strong presentation and client interaction skills
Accurate discernment on when to act independently and when to ask for guidance and/or assistance.
Required Education, Experience, and Licenses
Minimum 2 years of provider relations or credentialing experience preferred
Knowledge of Medicare and Medicaid is preferred
Proficiency in Microsoft Office (Word, Excel and Outlook) a must.
Knowledge of QNXT a plus!
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Essential Responsibilities
Answer provider inquiries through telephonic and email contact.
Onboard and orient new providers through follow-up telephone calls, webinars, etc.
Utilizing established templates, draft contracts for new providers and amendments for existing providers.
Conduct Access and Availability surveys.
Assist in creating and maintaining reports pertaining to providers.
Obtain single case agreements (SCAs) from non-contracted providers, maintain log, obtain countersignature, notify providers and appropriate internal departments.
Establish and update provider records on company systems, including Salesforce.com and QNXT.
Participate in Provider Relations projects and assigned tasks as necessary.
Specific Knowledge, Skills, and Abilities
Strong organizational skills.
Detail oriented with ability to shift gears and prioritize multiple demands.
Ability to interact effectively with a variety of people (such as physicians, medical office staff, administrative staff of nursing homes and home care agencies, etc.) as well as colleagues.
Good written and verbal communication skills
Ability to work independently but recognize when to elevate or seek help.
Strong presentation and client interaction skills
Accurate discernment on when to act independently and when to ask for guidance and/or assistance.
Required Education, Experience, and Licenses
Minimum 2 years of provider relations or credentialing experience preferred
Knowledge of Medicare and Medicaid is preferred
Proficiency in Microsoft Office (Word, Excel and Outlook) a must.
Knowledge of QNXT a plus!
#J-18808-Ljbffr