Remote Provider Relations Consultant

Evolving Solution Services; Murfreesboro (TN); Hybrid; USD 60,000 - 80,000; Full time

Job summary

PBACO is seeking a Provider Relations professional to act as the primary liaison between The Healthcare Network and the provider community across multiple product lines. You will build strong relationships, deliver routine and targeted education visits, and support policies, initiatives, and billing guidelines.

Incumbent must be able to work independently as a telecommuter and attend off-site meetings, including overnight stays. Driving is required for extended periods and provider office visits.

Qualifications

• 2 years’ experience in Provider Relations and/or Managed Care Product Administration.
• Valid unrestricted driver’s license.
• Bachelor’s degree in Business Administration, Marketing, Health Care Administration or Other Related Degree.
• 2 years’ Provider Relations experience or medical office or hospital experience.
• 2 years’ exposure to medical claims processing procedures.
• Knowledge of Managed Care dynamics including capitation and reimbursement structures.

Responsibilities

• Serve as the primary liaison between The Healthcare Network and the participating provider community to educate and coordinate across product lines.
• Conduct on-site visits, telephonic conversations and written communications with Hospital executives, Patient Account Managers, Physicians, Office and Billing Managers.
• Perform on-site provider orientations and group county orientations for new primary care and specialty care physicians regarding policies, procedures, billing and company-wide initiatives.
• Represent the Provider Consultant Department in workgroups and committees addressing provider concerns and network operations.

Skills

Provider Relations

Customer service

Problem solving

Communication

Managed Care

Education

Bachelor’s degree

Job description

PBACO is seeking a Provider Relations professional to act as the primary liaison between The Healthcare Network and the provider community across multiple product lines. You will build strong relationships, deliver routine and targeted education visits, and support policies, initiatives, and billing guidelines.

Incumbent must be able to work independently as a telecommuter and attend off-site meetings, including overnight stays. Driving is required for extended periods and provider office visits.