Provider Relations Specialist
4 weeks ago
Job Location
417 Washington Street - Columbus, IN
Remote Type
Hybrid
Travel Percentage
No Travel
Job Shift
Day Shift
Job Category
Health Care
Description
TITLE: Provider Relations Specialist
REPORTS TO: Provider Relations Supervisor
Job Summary: This non-exempt position requires exceptional attention to detail and precision. The Provider Relations Specialist is responsible for managing complex provider networks, executing meticulous contracting processes, and maintaining accurate credentialing information. This role demands a keen eye for detail in contract management, credentialing, and interdepartmental communication.
Ideal Candidate: We're seeking a detail-oriented professional who thrives on precision and accuracy. The ideal candidate will have a proven track record of managing complex contractual relationships, executing error-free documentation, and maintaining meticulous credentialing records. They will demonstrate an unwavering commitment to quality in all aspects of their work.
If you have a passion for excellence and an eye for detail that borders on perfectionism, we want to hear from you. Join our team and help us maintain the highest standards of accuracy and efficiency in our provider relations operations.
Key Responsibilities:
- Credentialing
- Conduct thorough research to verify and confirm credentialing information, including work history, malpractice history, and hospital privileges
- Prepare detailed files for SIHO Credentialing Committee review
- Manage the re-credentialing process for existing providers, ensuring all information is up-to-date and accurate
- Interdepartmental Collaboration and Support
- Provide precise network information to Sales, Account Management, Reinsurance, and Finance teams
- Collaborate closely with Health Systems Development on new business initiatives, ensuring all details are accurately communicated
- Support Provider Services Specialists with contractual issues, maintaining a high standard of accuracy
- Provider Relations and Education
- Establish and nurture provider relationships, paying close attention to individual needs and concerns
- Deliver comprehensive, error-free education to physicians, facilities, and ancillary providers
- Train newly contracted healthcare providers on SIHO's policies and procedures, ensuring complete understanding
Qualifications:
- Bachelor's degree in Healthcare Administration, Business, or related field
- Minimum 2 years of experience in healthcare provider relations or similar role
- Exceptional attention to detail and commitment to accuracy
- Strong analytical skills with the ability to manage and interpret complex contractual information
- Excellent communication skills, both written and verbal
- Proficiency in healthcare-related software and contract management systems
- Experience in a managed care organization preferred
- (Internal candidates) Current SIHO performance evaluation of at least "3" (Performance achieved requirements of job.)
- Strong communication (oral and written) skills
- Demonstrated problem solving and analytical skills
- Knowledge of health insurance, billing, and/or claims processing
- Ability to work at a self-directed pace in a changing, multi-task environment
- Professional appearance and presence
- Ability to project and maintain a positive attitude internally and externally
- Intermediate understanding of Word, Excel, database, and web-based technology
- Ability to maintain strict confidentiality
- Must be good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
- All positions are subject to change based on the needs of the business
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