Position Title: Provider Relations Associate Analyst

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Work Location: Remote

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Assignment Duration: 6+ months

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Work Schedule: Training hours are Monday through Friday 9:30 AM - 6:00 PM CST. After all of the training is completed, the hours for this position will be 10:30am-7:00pm CST.

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Work Arrangement: Remote

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Position Summary:

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The Claims & PR (Provider Relations) Advocate will service inbound claim calls from both members and providers or their office support staff. Occasional outbound calls are required to resolve claim issues.

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Background & Context:

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Contractors will initially be trained to take calls regarding Eligibility and Benefits from Behavioral Health Providers. This initial training is required before learning how to service Claim and PR (Provider Relations) calls.

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Timing for the Claim and PR training is yet to be determined, and will be based on business need.

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Key Responsibilities:

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* The primary responsibility of this role is to answer inbound claim calls from members or providers, as well as contracting and Provider Relations related calls from providers.

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* The work environment is structured, and the majority of the day will be spent answering these calls from a queue.

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* Occasional outbound calls may be necessary for issues requiring follow-up.

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* Assist a member or provider with understanding how a claim has processed

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* Verify claim status for a member or provider

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* Educate a member or provider on billing protocols

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* Write or correct authorizations to ensure claims are paid correctly

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* Send claims for adjustment/reprocessing

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* Request duplicate EOBs for a member or provider

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* Send a request for a cancelled check copy, to reissue a check, or request a stop pay/do not reissue on a check

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* Provide follow-up on issues by making outbound calls when necessary

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* Send resources to members and providers via email

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* Submit a complaint on the member or provider's behalf

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* Send handoff requets to matrix partners for escalated or complex issues

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* Assist providers with contract related inquiries and demographic updates

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* Independently problem-solve to ensure accurate information is given, exceptional customer service, and first call resolution is achieved

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Qualification & Experience:

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* Customer Service experience

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* Able to excel and/or prior successful experience in a virtual team environment

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* Ability to maintain a professional and positive image to members, providers, facilities, billing offices, etc.

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* Candidate must possess superb interpersonal communication skills

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* Effective listening and organizational skills, with the ability to manage multiple tasks

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* Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several claim systems and applications

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* Independent problem-solving skills

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* Strong time management skills

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* Ability to type effectively and have strong PC skills

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* A bachelor's degree is required.

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Additional Information:

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Please Note: this position is fully remote / work from home. At this time, candidates must be willing to complete all training and work from their home.

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The Organization will supply all equipment, however, high speed internet is required.

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Candidates must have reliable high speed internet connection at home - this will NOT be provided.

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Manager seeking candidates located anywhere in the U.S. Candidates located in PST or MST are ideal to staff our late shift.

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Training

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Training hours are Monday through Friday 9:30 AM - 6:00 PM CST.

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Work Schedule

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After all of the training is completed, the hours for this position will be 10:30am-7:00pm CST.

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Attendance Policy

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Maintaining good attendance is important for all contractors and is particularly important for those newly hired to the assignment.

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The Corrective Action process for a contractor who incurs an unscheduled or unapproved absence or event in his/her first 90 days of assignment is outlined below.

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1st unapproved absence or event will result in a Verbal Counseling.

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2nd unapproved absence or event will result in a First Notice.

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3rd unapproved absence or event will result in a Final Notice.

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4th unapproved absence or event will result in termination.

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Late Arrivals/Early Departures

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Late arrivals and early departures without the appropriate notifications count towards an unscheduled, unapproved absence. Based on business need, a manager may allow a contractor to make-up the time during that business day. However, this does not excuse the behavior.

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Recording of Late arrivals

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If an Advocate is late for any reason the following will determine how their time is recorded:

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7 minutes to 15 minutes will be recorded as an occurrence.

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15 minutes to 30 minutes will be recorded as an occurrence and time may be made up on the same day at the manager's discretion.

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30 minutes or more will be recorded as an occurrence and time will be recorded as unscheduled time off. No portion of this time can be made up.

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Any exceptions will be determined by the Supervisors.

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If the attendance issues become excessive and/or if a trend develops that adversely impacts the contractor's productivity, performance and/or contribution to the organization, management may accelerate the corrective action process.

","

Position Title: Provider Relations Associate Analyst

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As Billing Coding Specialist, using the established medical codes, transcribe patient history to be used by both health care providers and insurance companies. The Billing Coding Specialist updates the codes for services received and translates each code as it applies to the patient's healthcare insurance provider; prepares the claims document and submits, organizes, and tracks all insurance claims making sure that the payment is received. In addition, the Billing Coding Specialist deals with customers in terms of answering questions, arranging payment plans, and handling collections if a payment never materializes.\nFollow Willapa Behavioral Health Service Excellence Standards / Code of Ethics and Policies and Procedures\nAdhere to rules of confidentiality.\nRespect and accommodate a diverse population.\nMaintain appropriate boundaries with clients and staff.\nWork on-site as necessary or remotely using telehealth technology as determined by management.\nEssential Functions\nRead and analyze patient records; obtain clarification on notes and charts to ensure accuracy.\nEnsure all records are properly signed off on.\nAssign the correct codes to all diagnoses and services.\nEnter and organize the codes into the management software.\nBe familiar with ICD-9-CM, ICPM, DSM-IV, and CPT-HCPCS coding systems; using the codes, bill the insurance providers.\nTrack patient data over multiple visits.\nManage detail, specifically coded information.\nJob Requirements\nMinimum Qualifications\nHigh school degree\nWell organized: have the ability to formulate and follow efficient working procedures and guidelines.\nEffectively explain all charges to patients and their families and remain professional and empathetic in the face of dispute over charges and payment.\nTechnologically savvy: up to date with technological developments in the field, especially as it relates to software developments.\nExcellent verbal and written communication skills, computer proficiency to document in the electronic medical record (EMR) and utilize telehealth and Microsoft office suite.\nUndergo and pass criminal background check upon initial employment and any subsequent checks required by the agency.\nMeet requirements of agency's drug free workplace policy.\nExcellent customer service with a client focus.\nAble to sit, stand and move for long hours at a time and lift up to 25 pounds.\nA valid driver's license and reliable vehicle.\nAble to drive in daylight, darkness, and typical Northwest weather conditions.\nFlexible to fill-in shifts if needed.\nOther duties as assigned.\nMeet the current Washington health care vaccination requirements for health care workers.\nPreferred Qualifications\nCoding Certification by an Accredited organization and/or Associates Degree

","Billing Coding Specialist

As Billing Coding Specialist, using the established medical codes, transcribe patient history to be used by both...","Billing Coding Specialist",[120],["B","3269678240"],"Work at Willapa Behavioral Health and Wellness","4 days ago","/jobs/3269678240-billing-coding-specialist","Long Beach, WA, United States","/jobs?keyword=Willapa+Behavioral+Health+and+Wellness","/jobs?location=Long+Beach%2C+WA%2C+United+States","/jobs?keyword=Billing+Coding+Specialist",{"_66":67,"_68":121,"_70":122,"_72":123,"_74":124},"Long Beach","Long Beach, WA, United States, 98631","WA","98631",["D",1776078000000],"Astrana Health","Provider Relations Representative

We are currently seeking a driven Provider Relations Representative who will be responsible of both field and office activities in providing supports to the IPA's provider network. This role involves collaborating with contracted providers to ensure comply with IPA and Health Plan standards. This is an in-person role that requires some travel in San Francisco and San Mateo County. Please see below for details.\nOur Values:\nPut Patients First\nEmpower Entrepreneurial Provider and Care Teams\nOperate with Integrity & Excellence\nBe Innovative\nWork As One Team\nWhat You'll Do

Respond to provider inquiries via phone, email, or in person, in a timely and professional manner\nAssist providers with billing questions, claim status, and account access issues\nCommunicate company procedures, updates, and compliance requirements to providers\nEscalate complex issues to the appropriate internal departments for resolution\nDocument interactions and maintain accurate provider records in the system\nOther duties as assigned\nQualifications

Must always have and maintain a reliable source of transportation\nAssociate's degree in healthcare administration, business, or a related field preferred\n1-2 years of experience in provider network management, or a similar role within the healthcare industry\nExcellent written and verbal communication skills\nMust be able to frequently travel to designated service regions as required\nProficient computer skills and Microsoft Office programs (i.e., Outlook, Excel, Word, and PowerPoint)\nYou're great for the role if:\nYou enjoy helping others by providing clear and friendly support\nYou're a strong communicator who can explain processes and answer questions accurately\nYou work well both independently and collaboratively with internal teams\nYou're adaptable and thrive in a dynamic environment, embracing change and continuous improvement\nEnvironmental Job Requirements and Working Conditions

Our organization follows an in-person work structure where the expectation is to work in office and travel on a weekly basis.\nThis is a field representative position that requires travel to provider offices in San Francisco and San Mateo County. Travel is expected to be approximately 30% of your time, but it could vary depending on current projects or assignments. Anytime that you are not traveling, you will be working out of one of the two corporate office sites below.\nDaly City office: 355 Gellert Blvd, S 200, Daly City, CA 94015\nSan Francisco office: 827 Pacific Ave, San Francisco, CA 94133\nWork hours are Monday through Friday 8:30am-5:00pm PST. Occasionally required to work overtime and/or during the weekend.\nThe total compensation target pay range for this role is $28 - $33 per hour. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.\nAstrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.\nThe job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.\nAbout Astrana Health, Inc.

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.\n","Provider Relations Representative

We are currently seeking a driven Provider Relations Representative who will be responsible of both fiel...","Provider Relations Representative",[138],["B","3269767827"],"Work at Astrana Health","/jobs/3269767827-provider-relations-representative","South San Francisco, CA, United States","/jobs?keyword=Astrana+Health","/jobs?location=South+San+Francisco%2C+CA%2C+United+States","/jobs?keyword=Provider+Relations+Representative",{"_66":67,"_68":139,"_70":140,"_72":104,"_74":141},"South San Francisco","South San Francisco, CA, United States, 94083","94083",1072,"name","Hearst Television","agency","logo","slug","hearst-television","

Every career with Hearst Television is like a story. How it develops, where it takes you, the milestones you reach along the way – you’ve got a lot to look forward to as your unique career story unfolds. Hearst Television, a subsidiary of Hearst, owns and operates local television and radio stations serving nearly three dozen U.S. cities, reaching 24 million U.S. television households. Through its partnership with nearly all major networks, Hearst Television distributes national content across more than 120 video channels, including programming from ABC, NBC, CBS, CW, MY Net, MeTV, This TV, Estrella, and more. Hearst Television is recognized as one of the industry's premier companies. It has been honored with numerous awards for distinguished journalism and industry innovation, including the Walter Cronkite Award for political journalism, the national Edward R. Murrow Award, the DuPont-Columbia Award, and the George Foster Peabody Award.

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Join the leading career community for creative, marketing, and media professionals.","Sign Up | Creative, Marketing & Media Job Search",{"_37":282},{"_143":32,"_276":281},"Never miss an opportunity. Sign up for free email alerts and get the latest jobs in social media, graphic design, writing, and marketing delivered to your inbox.","Create Job Alerts | Media, Marketing & Creative Job Alerts",[379,380],{"_37":377,"_339":378,"_32":40},"unlimitedJobsEmail","clients@mediabistro.com","enterpriseCta",{"_373":374,"_375":376},{"_370":25,"_371":25,"_372":25},"mediaBoardSection",{"_37":360,"_339":361,"_32":362,"_363":364,"_358":365},"rolesSection",{"_37":355,"_339":356,"_32":357,"_358":359},"testimonialsSection",{"_37":352,"_339":353,"_32":354},"testimonials",[340,341,342],"employersSection",{"_37":338,"_339":235},"employerLogos",[302,303,304,305,306,307,308,309,310,311,312,313],{"_143":336,"_315":337},{"_143":334,"_315":335},{"_143":332,"_315":333},{"_143":330,"_315":331},{"_143":328,"_315":329},{"_143":326,"_315":327},{"_143":324,"_315":325},{"_143":322,"_315":323},{"_143":320,"_315":321},{"_143":144,"_315":319},{"_143":317,"_315":318},{"_143":314,"_315":316},"Leaf Group","image","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/leaf-group-400x200.png","Cox Enterprises","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/cox-enterprises-400x200.png","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/hearst-television-400x200.png","Future","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/future-400x200.png","Fox Corporation","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/fox-corporation-400x200.png","Penguin Random House","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/penguin-random-house-400x200.png","Springer Nature","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/springer-nature-400x200.png","Penske Media Corporation","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/penske-media-corporation-400x200.png","Dotdash","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/dotdash-400x200.png","Meredith","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/meredith-400x200.png","Bloomberg","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/bloomberg-400x200.png","NBCUniversal","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/nbc-universal-400x200.png","Media and Creative Employers on","subtitle",{"_343":349,"_345":350,"_146":351},{"_343":336,"_345":348,"_146":337},{"_343":344,"_345":346,"_146":347},"company","The Taunton Press","quote","What we like best about Mediabistro is the quality of targeted talent they deliver through their job board portal. We know we'll find the right type of talent for specialized positions that may be more challenging to fill. For almost fifteen years, Mediabistro has been our go-to resource for talent in the media/publishing space.","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/taunton-press-400x200.png","Mediabistro is valuable partner when it comes to finding top candidates in the media industry. Their team is extremely responsive, which makes the posting process quick and easy. They also offer great insight into branding company pages.","Huffpost","I love using Mediabistro for my harder to fill creative roles. Multimedia positions like photo editors, video producers, or even niche journalists yield great results. Other job boards don't always produce the specialized talent my hiring teams are looking for, and I feel like I can find that talent through Mediabistro.","https://production-rails-default.s3.us-east-2.amazonaws.com/public/post-jobs-logos/huff-post-400x200.png","Trusted by Leading Media","and Creative Employers","See why top publishers, agencies, and brands rely on us to find exceptional talent.","Hire Remote and Local Talent","Across Every Media Vertical","Whether you are building an in-office team or seeking remote talent, access a specialized network of professionals in editorial, publishing, influencer marketing, and AI content strategy. Find candidates—from prompt engineers to production leads—who are ready to contribute from anywhere.","imageAlt","Media roles infographic","The #1 Destination for Media","and Creative Talent","Connect with top-tier full-time and freelance media professionals. Whether you are a leading publisher, a streaming service, or a growing brand, we deliver specialized talent you won't find on generalist job boards. Find your perfect match for:","bullets",[366,367,368,369],"Job seekers and featured job cards collage","News, Journalism & Book Publishing","Content Marketing, AI Prompt Engineering & Copywriting","Influencer Management, TV & Video Production","PR, Non-Profits & Education","showMediaBoardSection","showRolesSection","showPlanIcon","text","*Unlimited plan is for direct employers only. Hiring at scale, posting on behalf of clients, or distributing across job boards?","linkText","Contact us for custom volume pricing, multi-brand support, and programmatic distribution.","The #1 Job Board for Media, Marketing & Creative Talent","Skip the unqualified resumes. Reach journalism, publishing, and marketing pros who are ready to work.",{"_37":382},{"_143":32,"_276":381},"Recruit qualified media and creative professionals on the #1 industry job board. 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