Provider Relations Representative - 1199 Seiu National Benefit Fund : Job Details

Provider Relations Representative

1199 Seiu National Benefit Fund

Job Location : New York,NY, USA

Posted on : 2024-12-17T23:37:06Z

Job Description :
Responsibilities
  • Establish provider education, contractual agreements with physicians, dental providers, practitioners, and the 1199SEIU Benefit and Pension Funds
  • Act as the primary liaison between the Fund and provider network; identify key non-participating providers with the intention of securing a contract for recruitment purposes
  • Perform on-site visits to participating providers to offer continued education and training
  • Coordinate and conduct provider recruitment activity, network analysis including contract negotiations and network retention to ensure network adequacy in assigned territories
  • Update participating providers regarding new policies and procedures. Review existing policy to ensure maximum compliance, troubleshoot issues raised by provider and distribute any needed material
  • Identify non-compliant providers, and providers with member complaints; communicate provider specific problems to management and propose remedy
  • Responsible for keeping abreast of departmental specific goals and reinforcing these goals to providers
  • Maintain accurate records of contacts and reports
  • Perform additional duties and projects as assigned by management
Qualifications
  • Bachelor's degree in business or health related field
  • Minimum two (2) years managed care, provider contracting or provider services experience required
  • Knowledge of healthcare terminology required, familiarity with contracting language and fee negotiations
  • Ability to travel throughout assigned territories
  • Basic skill level in Microsoft Word and Excel preferred
  • Excellent written and oral communication skills; effective customer service skills
  • Excellent interpersonal skills; ability to maintain productive work relationships with various providers, departments, and professionals at all levels
  • Good problem solver with excellent analytical skills
  • Demonstrated organizational skills, record keeping, and time management skills
  • Able to work well independently, handle multiple projects and assignments, and follow through to completion
  • Must have a valid driver license and ability to drive and travel extensively to various locations
Apply Now!
Similar Jobs ( 0)
-- View More Similar Jobs --