Provider Relations

Ampcus, Inc; Baltimore (MD); On-site; USD 46,000 - 66,000; Full time

Job summary

Ampcus Inc. is seeking a Provider Relations professional in Baltimore, MD to support the provider contracting process. You will respond to complex inquiries from network providers and care partners and coordinate related workflows with internal teams.

The role emphasizes administrative coordination, documentation upkeep, and staying current with health plan offerings and reimbursement models to ensure timely, professional service.

Qualifications

• Interest in understanding the healthcare industry and health benefits.
• Strong writing and communication skills are essential.
• Attention to detail and accuracy in handling contracting inquiries.

Responsibilities

• Manage contracting email boxes and triage complex inquiries from provider practices or health care entities.
• Support and organize contracting workflows, including mailings, contracts, templates, and audits.
• Update and maintain documentation and SOPs; provide regular status updates to management.
• Maintain knowledge of insurance plans, product offerings, and reimbursement models.
• Perform other duties related to provider contracting and networks management.

Skills

Organizational skills

Effective writing

Deadline driven

Sense of urgency

Customer service & follow-up

Education

High School Diploma or GED

Tools

Microsoft Office 365

Job description

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Job Title: Provider Relations

Location(s): Baltimore. MD

PURPOSE:

• Performs a variety of administrative functions and coordination in support of the provider contracting process and initiatives. Responsible for responding to complex and escalated contracting inquiries from a variety of network providers and care partners related to Medicare, Medicaid, Commercial and DSNP contracts. Assists functional teams daily to ensure all requests are handled in a timely and customer focused, professional manner.

ESSENTIAL FUNCTIONS:

• 35% Manage Contracting email boxes. Works with the appropriate leader to triage and respond to complex and escalated inquiries from external provider practices or health care entities, as well as internal requests and bring to resolution in a timely manner, or elevate to an accountable party. Follows up to ensure resolution and/or assists with tasks to support resolution.


• 30% Supporting and organizing contracting related workflows including but not limited to: Carrying out ad hoc mailings, uploading and printing of contracts, updating fee disclosures, editing/updating templates, gathering documentation for audits or other regulatory requirements, researching returned mail and triaging complaints/inquires.


• 15% Update and maintain supporting documentation, process and standard operating procedures for the department. Provides regular updates to management with regard to identified and outstanding issues or trends.


• 10% Maintain in-depth knowledge of insurance plans, product offering and reimbursement models. Stays abreast of changes and trends in Health Care.


• 10% Other duties related to provider contracting and networks management as assigned.

Skills:

• Super Skills/Competencies


• Organizational skills.


• Effective writing skills.


• Deadline driven.


• Sense of urgency.


• Proficiency with Microsoft Office 365 to include proficient and successful utilization of Word, Excel, Outlook and teams.


• Great customer service and follow up skills.

Qualifications

• Interest in understanding the healthcare industry, health environment, health insurance payer environment.


• Understanding of Health benefits.

Preferred Qualifications

• A High School Diploma or GED is required.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.