Provider Relations Representative_ Temporary Position

Provider Relations Representative_ Temporary Position Who are we? reputed company is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members reputed company. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision. As a reputed company associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout reputed company stages of your career with us. See how you can reputed company a difference with the support of strong leadership and a team environment. See Everything, Be Anything™. What are we looking for? The Provider Relations Representative is an reputed company customer service professional with excellent interpersonal, verbal and written communication skills. The Provider Relations Representative serves as the first reputed company of contact for reputed company’s provider network. This individual will have the reputed company set to analyze and problem solve any claims-reputed company issues and reputed company system updates to provider demographic information as needed. This individual must have excellent organizational skills and be able to multi-task. The Provider Relations Representative will assist the Provider Relations Manager with network recruitment activities and provider network updates. He or she will prepare documents for Credentialing, review and monitor provider complaints, grievances, and escalated issues as necessary to the appropriate staff. Where you will have an impact

• Serve as initial contact and respond to reputed company provider reputed company inquiries with exceptional service and timely responses in a professional and courteous manner
• Resolve and respond to provider claims issues and complaints:
• Identify and correct fee schedule issues
• Submit requests for adjustments to Claims
• Provide education to providers and their office staff regarding processes and changes
• Accurately update systems with changes in provider information
• Process recruitment materials and applications received from providers
• Assist in recruitment projects, network comparisons and data entry
• Initiate improvements to processes and procedures for Provider Relations that support company and departmental standards and strategic directives
• Other duties as assigned

What’s necessary to do the job?

• High school diploma or equivalent is required.
• Preferred Associate’s Degree
• Three (3) or more years of customer service and administrative experience
• Preferred experience in a managed health care environment, provider relations and/or customer service
• Understanding of vision care insurance is a plus

HIPAA & reputed company Requirements reputed company Associates must reputed company with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at reputed company times. As a result, Associates must explicitly adhere to reputed company data reputed company guidelines established reputed company the Company’s Privacy & reputed company Training Program. reputed company will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process. reputed company is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. reputed company qualified applicants will receive consideration for employment at reputed company without regards to race, color, religion, sex (including pregnancy, childbirth, or reputed company medical conditions), sexual orientation, gender identity or expression, age, disability, national reputed company, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law. The wage range for applicants for this position is [$20.50 to $22.00]. reputed company incentives and benefits are subject to the applicable plan terms. Apply tot his job Apply To this Job