Provider Relations Representative_ Temporary Position

Versant Health•San Antonio, TX

39d

About The Position

Provider Relations Representative_ Temporary Position SEE how you can make a difference! Be part of an innovative company that cares about its associates and helps members enjoy the wonders of sight through healthy eyes and vision. Versant Health provides vision care to 37 million members nationwide! To ensure your continued success we provide opportunities for advancement and development. Our associates remain engaged through a comprehensive compensation and benefits package which includes health and dental insurance, tuition reimbursements, 401(k) with company match, pet insurance and FREE vision insurance for you and your family. Scope and Purpose of Position The Provider Relations Representative is an experienced customer service professional with excellent interpersonal, verbal and written communication skills. The Provider Relations Representative serves as the first point of contact for Superior Vision’s provider network. This individual will have the skill set to analyze and problem solve any claims-related issues and make system updates to provider demographic information as needed. This individual must have excellent organizational skills and be able to multi-task. The Provider Relations Representative will assist the Provider Relations Managers with network recruitment activities and provider network updates. He or she will prepare documents for Credentialing, as well as, review and monitor provider complaints, grievances, and escalated issues as necessary to the appropriate staff.

Requirements

High school diploma or equivalent is required.
Requires three (3) or more years of Customer Service and administrative experience.

Nice To Haves

Associates Degree is preferred
Previous health care experience in a managed health care environment (including Medicare / Medicaid), provider relations or customer service, including working with members and providers is preferred.
Understanding of vision care insurance is a plus

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
Perform other related duties as assigned