Remote Provider Relations Specialist

PBACO Holding LLC; Florida; Remote; USD 60,000 - 85,000; Full time

Job summary

PBACO Holding LLC is seeking a Provider Relations professional to serve as the primary liaison between The Healthcare Network and the provider community in Florida. The role emphasizes educating primary and specialty care physicians on policies, initiatives, billing and eligibility, with on-site visits and telecommuting flexibility.

You will conduct provider orientations, coordinate group county sessions, and support claims and benefits guidance while building lasting relationships.

Qualifications

• 2 years’ experience required in Provider Relations and/or Managed Care Product Administration.
• Valid unrestricted driver’s license.
• 2 years’ Provider Relations experience or medical office or hospital experience.
• 2 years’ exposure to medical claims processing procedures.
• Knowledge and understanding of the dynamics of Managed Care environment, including capitation and reimbursement structure.

Responsibilities

• Serve as the primary liaison between The Healthcare Network and the participating provider community who service our members in multiple product lines throughout the network.
• Build and maintain strong relationships with providers by offering excellent customer service to assigned primary care and specialty care physicians with routine and targeted education visits for the purpose of continued education regarding policies/initiatives.
• 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 that address both internal and external customer concerns regarding the operations of The Healthcare Network as it pertains to the provider community.
• Other duties as assigned.
• Applicant must be highly proficient and creative at identifying and solving problems.

Skills

Provider Relations

Managed Care

Customer Service

Problem Solving

Education

Bachelor’s degree in Health Care Administration

Bachelor’s degree in Business Administration

Bachelor’s degree in Marketing

Job description

PBACO Holding LLC is seeking a Provider Relations professional to serve as the primary liaison between The Healthcare Network and the provider community in Florida. The role emphasizes educating primary and specialty care physicians on policies, initiatives, billing and eligibility, with on-site visits and telecommuting flexibility.

You will conduct provider orientations, coordinate group county sessions, and support claims and benefits guidance while building lasting relationships.