Provider Relations Representative

Blue Cross of Idaho•Bozeman, MT

2d•$26 - $32

About The Position

Blue Cross of Idaho (BCI) is seeking a Provider Relations Representative to act as a primary liaison between the organization and healthcare providers. In this independent role, you will maintain open communication regarding provider policies and payment procedures while training and education providers on BCI contact requirements and operational procedures. We are looking for a Provider Relations Rep with: Provider Relations Rep I: Experience: 4 years' provider service or health industry experience Education: High School or equivalent Provider Relations Rep II: Experience: 8 years' provider service or health industry experience Education: High School or equivalent What your day may look like: Coordinates the resolution of provider contracts, agreements, fee schedules, and payment problems. Collaborates with key stakeholders to identify and resolve issues. Coordinate’s resolution of contract or agreement issues. Communicates critical issues and provides recommendations to leaders. Educates providers on policies, procedures, practices, and data integrity. Ensures providers are informed on changes/updates to policies, procedures, and practices. Ensures department and provider compliance with regulatory agencies. Coordinates cross departmental activities and projects to support and adhere to the provider contract requirements. Performs research to respond to inquiries and interprets policy and procedures to determine effective response. Provides welcome information to newly contracted providers. Promotes provider participation in on-line tools and programs available. Performs other duties and responsibilities as assigned. As of the date of this posting, a good faith estimate of the current pay range is $26.12 to $31.90. The position is eligible for an annual incentive bonus (variable depending on company and employee performance). The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer. We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program. We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies. Reasonable accommodations To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Blue Cross of Idaho has taken our role as an Idaho-based health insurance company to heart since 1945. As a not-for-profit, we are driven to help connect Idahoans to quality and affordable healthcare while building strong networks and services. We aim to create a brighter future for all with the help of customer-centric professionals. Your Health and Wellness Matters At Blue Cross of Idaho, we care about the health and well-being of our employees. Our benefits aim to help make your life easier, healthier and more balanced. Your Career Development Matters We believe in employee growth, which is why we offer training, tools and numerous resources to assist with professional development. Your Community Matters Our employees care deeply about Idaho. We work together to positively impact communities throughout Idaho, and contribute our time through volunteering. Blue Cross of Idaho will extend reasonable accommodations to qualified individuals with disabilities who are otherwise not able to fully use electronic and online job application systems. For assistance, please send an email to [email protected]. Equal Opportunity is the Law EEO is the Law Supplement E-Verify Pay Transparency

Requirements

Provider Relations Rep I: Experience: 4 years' provider service or health industry experience Education: High School or equivalent
Provider Relations Rep II: Experience: 8 years' provider service or health industry experience Education: High School or equivalent

Responsibilities

Coordinates the resolution of provider contracts, agreements, fee schedules, and payment problems.
Collaborates with key stakeholders to identify and resolve issues.
Coordinate’s resolution of contract or agreement issues.
Communicates critical issues and provides recommendations to leaders.
Educates providers on policies, procedures, practices, and data integrity.
Ensures providers are informed on changes/updates to policies, procedures, and practices.
Ensures department and provider compliance with regulatory agencies.
Coordinates cross departmental activities and projects to support and adhere to the provider contract requirements.
Performs research to respond to inquiries and interprets policy and procedures to determine effective response.
Provides welcome information to newly contracted providers.
Promotes provider participation in on-line tools and programs available.
Performs other duties and responsibilities as assigned.