Provider Relations Specialist

6 days ago

Raleigh, United States Insight Global Full time

Must haves:

  • Ability to explain and interpret program information to clients/customers and staff.
  • Experience working with Medicaid providers and/or in a healthcare setting
  • Ability to convey information and ideas through a variety of media to individuals or groups; ability to adjust language or terminology to meet needs of the recipient(s).
  • Ability to present ideas in written form; ability to adjust language or terminology to meet needs of the recipient(s); ability to use correct grammar, organization, and structure.
  • Ability to utilize office equipment and other technology (software and systems) to meet work needs - proven experience with Microsoft Suite of Products and Adobe products.
  • Ability to facilitate the flow of work and coordinate office support activities with other staff; ability to maintain internal and external contacts for work coordination.
  • Ability to understand issues, identify problems and opportunities to determine the appropriate course of action.



Plusses:

  • Working knowledge of Medicaid data collection and storage to compile, assimilate, and organize printed and electronic information



Day to day:

A government customer is looking for a Provider Relations Specialist to join their team. This person will work with the provider relations and outreach team to carry out the duties associated with onboarding Medicaid health care providers. he primary focus of this role is to be the Medicaid subject matter expert to provide front-line customer service to participating Medicaid health care providers. Serving as the Division of Health Benefits (DHB) Medicaid provider relations liaison, other key aspects of the role includes processing contracts and maintaining a detailed customer database/customer relationship management application. Other duties include:

  • Report activities involving implementation of program objectives using existing procedures or devising new methods as necessary as well as develops and/or revises work procedures ad methods, including necessary forms design
  • Trains employees in work procedures.
  • Maintain operations by following policies and procedures and reporting needed changes to management.
  • Resolve discrepancies by using standard procedures or returning incomplete information to the Business Manager for resolution.
  • Work with and assist Medicaid providers and health plans to help identify their pain points and developing plans for resolution.
  • Assist with opening accounts, updating account information and will work to resolve customer issues via phone or email to ensure timely resolution.


Duties performed may also include preparation of Medicaid documents and reports, composition of memos and letters, the use of office technology, compiling records, organizing and maintaining files, posting information, greeting, referring, assisting visitors, clients, staff, and others, mail distribution, and photocopying.

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