Hybrid Provider Relations Specialist

Health Care Service Corp.; United States; Hybrid; USD 63.000 - 114.000; Vollzeit

Zusammenfassung

Health Care Service Corporation (HCSC) is seeking a provider relations specialist to develop and maintain relationships with contracted providers across the nation. You will facilitate provider inquiries, educate on Medicaid/Medicare processes, and ensure contractual and financial requirements are met.

The role requires strong communication, analytical skills, and travel as needed, with a 3 days in-office / 2 days remote schedule.

Qualifikationen

• Bachelor’s degree AND 3 years of work experience in managed care, OR a minimum of 5 years’ work experience in a managed care environment.
• Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
• Demonstrated knowledge of Medicaid and Medicare business processes, including provider education and operational support.
• Effective interpersonal, analytical, presentation and communication skills.
• Knowledge of the health care industry.
• Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
• Knowledge of contracts, applications, and products.
• Understanding of provider reimbursement methods.
• Working knowledge of claims processing systems.
• Effective organizational and planning skills.
• Analytical skills.
• Ability to take initiative and work independently.
• Demonstrated ability to meet deadlines and work well under pressure.
• Clear and concise interpersonal, verbal and written communication skills.
• Collaboration skills resulting in business/process improvements/changes.
• PC experience and skills to include Word, Excel, PowerPoint, etc.
• Facilitation, presentation and analytical skills.

Aufgaben

• Develop and maintain cooperative working relationships with contracted providers across a national scope.
• Assist providers by educating and resolving provider inquiries related to Medicaid/Medicare processes.
• Track issues, identify trends, and evaluate providers to ensure contractual and financial requirements are met.
• Support providers on medical insurance and claims-related inquiries and provide education.
• Travel as needed for responsibilities, including overnight stays.

Kenntnisse

Interpersonal skills

Analytical skills

Communication skills

Presentation skills

Ausbildung

Bachelor’s degree

Managed care experience

Jobbeschreibung

Health Care Service Corporation (HCSC) is seeking a provider relations specialist to develop and maintain relationships with contracted providers across the nation. You will facilitate provider inquiries, educate on Medicaid/Medicare processes, and ensure contractual and financial requirements are met.

The role requires strong communication, analytical skills, and travel as needed, with a 3 days in-office / 2 days remote schedule.