Provider Relations & Onboarding Specialist

Acentra Health, LLC; Stati Uniti; In loco; USD 34.000 - 43.000; Tempo pieno

Descrizione del lavoro

Acentra Health, LLC is seeking a Provider Relations Coordinator to join our growing team. The role supports provider recruitment, enrollment, onboarding, and ongoing provider relations, acting as a liaison between providers, clients, and internal teams to ensure effective participation in programs and systems.

The position involves outreach, onboarding coordination, contract review, and handling inquiries about benefits, payments, and documentation, with HIPAA compliance and strong emphasis on

Competenze

• 2+ years of provider-facing experience in healthcare, such as health plan/provider relations, medical billing, claims adjudication, or revenue cycle management, including experience resolving provider inquiries related to claims, pricing, and payments
• Basic familiarity with Medicare and Medicaid payment rules relevant to provider claims
• Proficiency in Microsoft Office applications, including Outlook, Excel, and Word, with accurate data entry skills

Mansioni

• Conduct outreach to client-identified providers through phone, email, and other communication channels to support provider recruitment and network development
• Coordinate provider onboarding, screening, and enrollment activities, including explaining processes, assisting with required documentation, collaborating with the enrollment team, and resolving enrollment-related issues
• Support practitioner and provider organization onboarding and retention efforts to maintain effective provider network participation
• Review and prepare practitioner and provider organization contracts, including in-network, out-of-network, and single-case agreements
• Respond to incoming provider and client inquiries regarding benefits, procedures, documentation, payments, and other program-related matters, ensuring timely resolution and appropriate follow-up
• Manage customer service escalations, including phone queue and voicemail inquiries, in accordance with established workflows
• Review and respond to provider claims appeals, grievances, and payment disputes, applying medical coding and billing knowledge to resolve pricing and payment concerns and document decisions
• Maintain accurate provider and client records, including network information, provider responses, calls, case updates, requests, and referrals, in accordance with established procedures
• Track provider outreach activities, assess geographic network coverage, and prepare accurate client reports related to provider network performance
• Maintain provider policy documentation, communicate updates, and conduct provider training sessions and webinars to support understanding of program requirements, systems, and tools
• Collaborate with technical teams to support accurate configuration of Medicare billing codes and reimbursement methodologies
• Perform other duties as assigned to support internal and external customers and achieve client program objectives
• Read, understand, and adhere to all corporate policies, including policies related to HIPAA and its Privacy and Security Rules

Conoscenze

Provider relations

Healthcare knowledge

Microsoft Office

Data entry

Formazione

High school diploma

Bachelor's degree preferred

Strumenti

Microsoft Office

Descrizione del lavoro

Acentra Health, LLC is seeking a Provider Relations Coordinator to join our growing team. The role supports provider recruitment, enrollment, onboarding, and ongoing provider relations, acting as a liaison between providers, clients, and internal teams to ensure effective participation in programs and systems.

The position involves outreach, onboarding coordination, contract review, and handling inquiries about benefits, payments, and documentation, with HIPAA compliance and strong emphasis on