Provider Relations Representative
CareCore National - Albany, NY

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CareCore national is looking for a Provider Relations Representative who will be responsible for supporting the Provider Relations Manager by communicating the CareCore National Imaging Program Administration Policies and Procedures to CareCore National member physicians and contracting physicians. Other responsibilities of the position include, but are not limited to:

  • Establish and maintain working relationships with medical office personnel, CareCore National and contracting physicians.
  • Perform orientation and train CareCore National and contracting physicians' office personnel. Additionally, provides education and training as needed.
  • Work directly with CareCore National and contracted physicians on questions regarding CareCore National administrative policy and HMO/PPO/employer group contracts. Respond directly to CareCore National and contracted physician complaints and concerns on various matters related to CareCore National's business.
  • Provide support relative to credentialing and re-credentialing CareCore National and contracting physicians including communicating with CareCore National and contracting physicians and/or their respective office staff to receive completed applications and tentative contracts and working with internal staff to obtain information necessary to complete applications and contracts.
  • Assist in development and implementation of CareCore National and contracted physicians practice enhancement programs sponsored by and for CareCore National including billing service, office supply and equipment group purchasing program and collection service.
  • Act as a liaison between CareCore National physicians and contracted Provider Relations and suppliers to facilitate the delivery of contracted services and/or products to network physicians.
  • Participate in the development and implementation of procedures that will facilitate and/or improve services provided to CareCore National and contracted physicians.
  • Interact with other internal staff members to provide support with special projects or assignments as necessary.
  • Perform other work-related duties as requested.

  • Minimum Requirements:
    • An Associate's Degree or an equivalent combination of education, training and experience is necessary.
    • Two years of Provider Relations experience, which involved working with contract agreements, is necessary.
    • Proficiency in using a personal computer to enter/access information to generate reports is necessary.
    • Previous Provider Relations experience within a managed health care environment is desirable.
    • Some travel may be required.

    CareCore National - 12 months ago - save job
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    Since 1994, CareCore National has provided comprehensive, customized programs to health plan clients that seek to manage appropriate...