Provider Relations Coordinator
Liberty Health Advantage, Inc. - Melville, NY

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Position Description

Provider Relations Coordinator

Major Purpose of Job:
The Provider Relations Coordinator supports the Provider Relations department through credentialing and provider database maintenance activities . Acts as a resource for other departments o n special projects.

Essential Job Functions:
  • Respond s to phone calls and e-mails from providers concerning provider participation, additions, terminations, etc. and forward to PR Manager as necessary. Enter all calls with providers in the database contact form.
  • Assist with the daily activities associated with the credentialing process :
o Tracking of all credentialing activities for LHA contracted providers
o Coordinates and documents all mailing s associated with credentialing activities.
o Preparation of mailings queries of the key elements for Primary Source V erification
o Performs out-going calls to obtain necessary credentialing documents
o P reparation of files to be presented to the credentialing committee meeting.
o Prepares reports to manager to review before credentialing committee.
o Assist in coordinati on of credentialing meetings ; typing and fil ing of meeting minutes.
  • Maintain provider database and hard copy files of contracted providers. Entry of new providers , terminations and changes as reported from delegated entities. Distributes information through appropriate channels within LHA. Maintains correspondence log of all additions and changes.
  • Prepares monthly provider termination report. Maintains termination log.
  • Acts as the coordinator of special projects in Provider Relations and other departments when necessary
  • Assist with departmental administrative duties
  • Assist with the mail ing of Member Identification Cards and New Member Kits
  • Performs other duties as required/needed
Education/Experience Requirements:
  • High school diploma
  • Ability to work independently and interact well with other departments and co-workers
  • Ability to organize and prioritize work to meet deadlines
  • Strong knowledge of Microsoft Office products (Word, Excel, Access)
  • Strong verbal, written, interpersonal, grammar, and proofreading skills
  • Understanding of the provider relations and credentialing
The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities and qualifications required.

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