Provider Relations Representative

Health Care Service Corporation•Houston, TX

2d•Remote

About The Position

This position is responsible for providing support, as well as developing and maintaining cooperative working relationships with contracted providers. Responsible for facilitating and enhancing provider ease of doing business with HCSC. This includes issue tracking and resolution, educating, training, identifying trends and evaluating providers to ensure that all contractual and financial requirements are adhered to and performed.

Requirements

Bachelor’s degree and 3 years of work experience in managed care, or a minimum of 5 years’ work experience in a managed care environment.
Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
Effective interpersonal, analytical, presentation and communication skills.
Knowledge of the health care industry.
Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
Knowledge of contracts, applications, and products.
Understanding of provider reimbursement methods.
Working knowledge of claims processing systems.
Effective organizational and planning skills.
Analytical skills.
Ability to take initiative and work independently.
Demonstrated ability to meet deadlines and work well under pressure.
Clear and concise interpersonal, verbal and written communication skills.
Collaboration skills resulting in business/process improvements/changes.
PC experience and skills to include Word, Excel, PowerPoint, etc.
Facilitation, presentation and analytical skills.

Responsibilities

Providing support to contracted providers.
Developing and maintaining cooperative working relationships with contracted providers.
Facilitating and enhancing provider ease of doing business with HCSC.
Issue tracking and resolution.
Educating and training providers.
Identifying trends and evaluating providers to ensure contractual and financial requirements are met.