The Provider Service Representative (PSR) plays a critical role in managing relationships with healthcare providers, ensuring smooth onboarding and contracting processes, and overseeing the accuracy of provider data within the system. This position is responsible for providing high-quality service to providers, resolving inquiries, facilitating contracting agreements, and maintaining up-to-date provider information in databases.
Key Responsibilities :
- Provider Services & Support :
- Serve as the primary point of contact for healthcare providers, responding to inquiries and resolving issues related to contracts, rates, and escalations.
- Assist with provider contracting, onboarding, and education, ensuring proper enrollment and access to necessary tools and resources.
- Address and resolve provider complaints and issues, escalating to management when necessary.
- Contracting :
- Coordinate the contracting process for new and existing providers, including drafting and reviewing contracts to ensure compliance with regulatory and network requirements.
- Collaborate with the contracting team to negotiate and finalize provider agreements, ensuring fair terms aligned with company policies.
- Track contract statuses and ensure timely renewals, amendments, and terminations.
- Provider Data Management :
- Ensure the accuracy and integrity of provider data, including demographic details, specialties, affiliations, and contract terms.
- Regularly update and audit provider data for compliance with standards.
- Coordinate with the data management team to identify and correct discrepancies promptly.
- Maintain accurate provider directories for internal and external use.
- Cross-Functional Collaboration :
- Work with internal teams such as Claims, Credentialing, Compliance, and Network Management to ensure smooth operations.
- Contribute to process improvements to enhance provider experience and operational efficiency.
- Reporting and Analysis :
- Generate reports on provider inquiries, contract statuses, and data accuracy.
- Analyze data trends and provide insights to leadership for decision-making.
Qualifications :
- Education : Bachelor or higher degree required.
- Experience : 3+ years in provider services, healthcare operations, or related fields; experience in healthcare contracting and data management preferred.
- Knowledge : Familiarity with healthcare systems, networks, regulations, and provider data systems.
- Language Skills : Proficiency in English and French required; additional languages are a plus.
- Skills : Strong communication, interpersonal, organizational, and problem-solving skills; proficiency in Microsoft Office; ability to work independently and in teams; attention to detail and ability to manage multiple tasks.
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