Provider Relations Liaison: Health Plan Partner

Prime Healthcare; Ontario (CA); On-site; USD 34,000 - 38,000; Full time

Benefits offered by this job

401K retirement plan

Medical, dental, and vision coverage

Paid time off

Job summary

Prime Healthcare in Ontario, CA is hiring a Provider Relations Representative to act as the main contact for providers and to bridge Prime Healthcare Employee Health Plan with medical providers.

You will maintain contract and practice information, respond to claim inquiries, benefit questions, and member issues, while documenting interactions with precision and timeliness. Strong communication and problem-solving are essential.

Qualifications

• Must have high school graduate or healthcare administration/business degree.
• 1 year of provider services or provider contracting experience in healthcare.
• Knowledge of CPT/ ICD-10 codes and billing terms.
• Strong communication, problem-solving and customer service.
• Computer literacy in Microsoft Office Windows.

Responsibilities

• Serve as primary contact for providers and liaison between health plan and providers.
• Maintain current contract and practice information and address inquiries.
• Document interactions accurately and timely to support efficient service.

Skills

Communication skills

Customer service

Problem-solving

Microsoft Office

Education

High School Diploma or equivalent

Associate's degree preferred

Tools

Microsoft Office

Job description

Prime Healthcare in Ontario, CA is hiring a Provider Relations Representative to act as the main contact for providers and to bridge Prime Healthcare Employee Health Plan with medical providers.

You will maintain contract and practice information, respond to claim inquiries, benefit questions, and member issues, while documenting interactions with precision and timeliness. Strong communication and problem-solving are essential.