Senior Provider Network Representative

HCSC Group; Austin (TX); On-site; USD 56,000 - 124,000; Full time

Job summary

HCSC in Austin, TX is seeking a skilled provider relations professional to plan and direct recruitment and contracting activities, educate providers on plan benefits and reimbursement, and provide ongoing service and support.

The ideal candidate has a bachelor’s in business or 6 years leadership experience, plus several years in claims or provider relations, with strong negotiation, travel ability, and proficiency in Microsoft Office.

Qualifications

• Bachelor’s degree in business or 6 years leadership experience.
• 4 years’ experience in claims, customer service, physician office or hospital environment.
• 3 years’ experience in physician/provider relations, including contracting and reimbursement.
• Ability to negotiate and contract with healthcare providers.
• Proficient with Microsoft Office and able to work independently.
• Willingness to travel; able to travel overnight.
• Strong organizational and planning skills.

Responsibilities

• Plan and direct provider recruitment and contracting activities.
• Educate providers on plan benefits, policies and reimbursement.
• Provide ongoing provider service and support.
• Resolve complex provider issues and liaise with internal partners.
• Train new and existing network staff.

Skills

Leadership

Negotiation

Provider relations

Microsoft Office

Travel

Multi-tasking

Independent worker

Education

Bachelor’s degree in business

Tools

BCBSTX systems

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for planning and directing provider recruitment and contracting activities; educating providers on plan benefits, policies, procedures, and reimbursement processes; providing ongoing provider service and support; resolving complex provider issues; serving as a liaison between providers and internal business partners; and providing training to new and existing network staff.

Required Job Qualifications:

• Bachelor’s degree in business OR 6 years leadership experience.
• 4 years’ experience in claims, customer service, physician office or hospital or healthcare environment.
• 3 years’ experience in a position which requires in-depth physician/provider relations, including but not limited to, contracting and reimbursement issues.
• Ability to negotiate and contract with healthcare providers.
• Platform skills; organizational and planning skills; and ability to take initiative and work independently.
• Ability to multi-task; meet deadlines and work well under pressure.
• Ability and willingness to travel within assigned areas of responsibility, including overnight stays.
• PC proficiency to include Microsoft Office

Preferred Job Qualifications:

• Demonstrated success building and maintaining relationships with physician groups, hospitals, and provider leadership.
• Experience conducting provider education, training, and face-to-face consultations.
• Experience resolving complex claims, reimbursement, and payment issues for providers.
• Extensive Medicaid and Medicare Advantage experience.
• Knowledge of healthcare contracting, reimbursement methodologies, and managed care operations.
• Prior territory management experience.
• Knowledge of BCBSTX claims processing systems.

Additional Details

Client-site Location: This is a field-based position in the Austin Texas market that requires provider office visits.

Sponsorship: Sponsorship is not available

Compensation: $55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards