Provider Relations Representative
About The Position
Versant Health is seeking an experienced customer service professional with excellent interpersonal, verbal, and written communication skills to join their team as a Provider Relations Representative. This role serves as the primary point of contact for Versant’s provider network, analyzing and problem-solving claims-related issues, and updating provider demographic information. The position requires strong organizational skills and the ability to multitask. The Provider Relations Representative will also support the Provider Relations Manager with network recruitment activities and provider network updates, prepare documents for Credentialing, and review/monitor provider complaints, grievances, and escalated issues.
Requirements
- High school diploma or equivalent is required.
- Three (3) or more years of customer service and administrative experience
- Understanding of vision care insurance is a plus
- All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI)
- Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times.
- Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Nice To Haves
- Preferred Associate’s Degree
- Preferred experience in a managed health care environment, provider relations and/or customer service
Responsibilities
- Serve as initial contact and respond to all provider related inquiries with exceptional service and timely responses in a professional and courteous manner
- Resolve and respond to provider claims issues and complaints
- Identify and correct fee schedule issues
- Submit requests for adjustments to Claims
- Provide education to providers and their office staff regarding processes and changes
- Accurately update systems with changes in provider information
- Process recruitment materials and applications received from providers
- Assist in recruitment projects, network comparisons and data entry
- Initiate improvements to processes and procedures for Provider Relations that support company and departmental standards and strategic directives
- Other duties as assigned
Benefits
- medical, dental, and paid vision coverage
- paid time off and company holidays
- retirement savings with employer contribution
- employee wellness resources
- professional development opportunities
- flexible work arrangements
- employee assistance programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
