Junior Provider Relation Consultant

Summary

As Junior Provider Relation Consultant, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• Supports Region Provider Relation Team with investigating and responding to complex issues reported from the provider community and State partners within response time standards. Including but not limited to researching, educating, responding, and documenting. 
• Responsible to create and maintain professional relationships within the medical provider community and actively promote communication with medical partners in outreach efforts
• Supports team with development and deliver education materials to providers, Associations, internal and contract management staff in group and individual settings.
• Provides backend support to Provider Relations team for training venues: one on one, large provider group sessions, virtual meetings via TEAMS or Skype, community workshops and large presentation conferences.
• Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement. Identifies issues and reviews, recommends, and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.

What we're looking for

• Two or more years of experience with business process service delivery and improvement, preferably in an outsourcing environment
• Experience working with client company industry and/or functional area and experience working with business solutions software
• Proven experience with issue resolution focused on claims research, provider enrollment, requirement compliance and customer service.
• Ability to perform within defined quality/metrics goals to achieve service level agreements.   

What you should expect in this role

• Strong written and verbal communication skills, computer and business solutions software skills, proficient knowledge of Microsoft Office and organization and time management skills
• Ability to investigate complex inquiries while leveraging requirements to promote successful outcomes and ability to work independently and as part of a team
• Billing/Credentialing in Providers office, Billing Agency, State Office or Payer’s office with direct contact to plan enrollment, medical billing, claims research and resolution, plan/policy interpretation and education delivery and Instructor level training and presentation delivery
• Remote position and may perform site visits to providers office in accordance to service level agreement.
• Travel may be required to present and participate at various located Healthcare conferences, townhalls, training venues and team onsite meetings at Boise Office.  

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