Provider Relations Coordinator

INNOVATIVE INTEGRATED HEALTH•Fresno, CA

2d•$23 - $28

About The Position

The Provider Relations Coordinator is responsible for coordinating and maintaining service relationships with Innovative Integrated Health (IIH) providers including physicians, hospitals, ancillary service providers and long-term care facilities. Responds to electronic and direct inquiries from providers about policies, claims, patient referrals, authorizations, and credentialing. The Provider Relations Coordinator will provide support to the Provider Relations Administrators on projects such as provider outreach and engagement, provider office roster updates, and provider training initiatives. The Provider Relations Coordinator oversees the credentialing and re-credentialing process by gathering all necessary and required documentation while ensuring timely completion. This role also maintains accurate and current provider information within relevant data systems.

Requirements

Proficient knowledge of computer skills. MS Office (Word, Excel, Access, PowerPoint, and Outlook).
Knowledge of general office procedures, equipment and filing systems.
Ability to communicate effectively, both orally and in writing.
Ability to quickly learn department policies, procedures, goals, and services.
Skill: Attention to detail and accuracy.
Ability to change priorities regularly.
Minimum of one (1) year of demonstrated experience in the healthcare field, preferably in a provider relations or provider network support role.
Minimum of one (1) year of documented experience working with a frail or elderly population.
High School diploma or equivalent required
Valid CA Driver’s License

Nice To Haves

Managed care experience preferred.
Bachelor’s degree preferred.

Responsibilities

Initiating and maintaining effective channels of communication with provider offices.
Gathering, verifying and updating all pertinent information relating to participating healthcare providers.
Establishing and maintaining relationships with healthcare providers through e-mail and telephone outreach, prompt resolution of issues, and excellent customer service.
Performing intake of specialty providers and responding to inquiries related to credentialing, claims, demographics, letters of agreement, contracting, etc., as needed.
Handling and responding to requests and queries for both internal and external entities related to provider information, as necessary.
Answering questions from provider offices related to prior authorization requests, claims processing, and the provider portal
Support changing management efforts and promote a culture of collaboration and continuous improvement.
Assisting Provider Relations Administrators and working with provider offices to complete contracts and letters of agreement or assist with more complicated authorization queries received.
Conducting training on IIH policies, procedures and services with provider offices.
Maintaining a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare.
Attend and participate in staff meetings, in-services, projects, and committees as assigned.
Adhere to and support the center’s practices, procedures, and policies including assigned break times and attendance.
Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
May require use of personal vehicle, if applicable. If using a personal vehicle, a valid California Driver’s License, current proof of insurance, and vehicle registration are required.