The provider relations rep serves as a liaison to health care providers, facilities and vendors, and is responsible for establishing and maintaining strong, positive relationships by providing excellent service and education by telephone and in-person.
This position provides administrative support to the Medical Management department. Responsible for professional interaction with providers, including timely follow-up and resolution of issues by responding to telephone and written inquiries. Clarifies and resolves issues related to the provider network, member benefits, claims and utilization management procedures such as authorization or referral information.
Bachelors degree preferrred.
Three years experience working in a managed healthcare / insurance encironment, preferably in provider relations or customer service.
Knowledge of medical terminology and claims preferred.