Provider Relations Consultant - Educate Providers

001 BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health plans

401k plan

Life Insurance

Paid Time Off

On-site facilities

Job summary

BlueCross BlueShield of South Carolina is seeking a Provider Relations Consultant to build and maintain positive relationships with network hospitals, physicians, and dental practices in Columbia, SC. You will be the primary contact for provider issues, addressing contracts, reimbursement methodologies, and policy questions.

The role requires five years in healthcare/provider networks, a Bachelor's degree, strong analytical and communication skills, and willingness to travel.

Qualifications

• Bachelor's degree required; four years related experience acceptable with equivalence.
• Five years of healthcare/provider network experience; two with health plan programs.
• Ability to analyze problems and present solutions; strong communication and coordination skills.
• Willingness to travel and have reliable transportation.

Responsibilities

• Serve as point of contact for provider problems and issues.
• Address network contracts, reimbursement methodologies, and policies.
• Identify root causes and recommend changes to issues.
• Coordinate meetings for problem resolution.
• Educate providers on lines of business and policy requirements.
• Document provider communications in education database.
• Conduct trainings and workshops for providers.

Skills

Claims processing

Independent worker

Decision making

Customer service

Analytical skills

Presentation skills

Negotiation

Travel ability

Education

Bachelor's Degree

Tools

Microsoft Office

Microsoft Access

Job description

BlueCross BlueShield of South Carolina is seeking a Provider Relations Consultant to build and maintain positive relationships with network hospitals, physicians, and dental practices in Columbia, SC. You will be the primary contact for provider issues, addressing contracts, reimbursement methodologies, and policy questions.

The role requires five years in healthcare/provider networks, a Bachelor's degree, strong analytical and communication skills, and willingness to travel.