Provider Relations Representative in Baton Rouge

posted:
Location
Baton Rouge, Louisiana
Industry
Insurance
Job Type
Full-Time
Salary
US$ 15.00 - US$ 17.00 per hour
Reference Number
Z00004LND
Contact
Jenni Trussell, Spherion
Phone
(225)925-5686
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Job Description

Career opportunities available for provider relations representatives in the Baton Rouge area: 

SUMMARY DESCRIPTION

Representative acts as an internal contact and works in cooperation with the claims department, member service staff, and other internal staff as necessary to perform Provider services. Provider services vary and include maintaining accurate and current provider databases, resolving problems, and advising providers of new protocols, policies and procedures.  Representatives apply knowledge to diversified subject matter, requiring some judgment in established procedures and guidelines.  This team is a critical component to the delivery of quality healthcare services to our members by maintaining highly efficient and functioning relationships with providers. 

RESPONSIBILITIES INCLUDE BUT NOT LIMITED TO:

- Assist in the basic operations of the Provider Relations Department

- Assist with the development and monitoring of provider contracts

- Resolve administrative problems affecting network providers, patients, and plans within                 contracted guidelines for which the network is responsible

- Assure the provider documentation is complete and accurate

- Process contracts and contract edits in multiple provider databases while ensuring the                 accuracy of the data

- Communicate any new or updated policy and/or procedure to providers

- Collect, clean and ensure the quality of data in the provider data systems

- Train others on new systems and serves as provider database helpdesk  

- Respond to phone calls and emails regarding network providers

- Communicate with large retail corporations, vendors and business partners

- Process dental and vision requests

- Update provider website

- Coordinate questions received via website

- Notify providers of new groups via mailings, email and phone calls

- Prepare reports for providers listing groups in their service area

- Prepare provider directories

- Request GEO Access reports

- Complete 1099 Projects/Returns

- Work with other departments, groups, members, and/or agents to resolve provider related                 issues s

- Coordinate vision screenings

- Assist in state reporting and filings

- Perform other duties as required

APPLY WITH SPHERION AND CONTACT OUR OFFICE FOR THIS CAREER OPPORTUNITY!

Skills

KNOWLEDGE, SKILLS & ABILITIES

- Ability to communicate in a professional and sales-oriented manner

- Excellent written and oral communication skills

- Strong critical thinking skills, listening, and problem solving skills

- Excellent attention to detail

- Strong Microsoft Office skills

Qualification

EDUCATION & EXPERIENCE REQUIREMENT

- Minimum 2 years of college

- 2-3 years related experience, preferably in the insurance industry

- Experience using the Internet and databases as research tools

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