![ElderwoodPediatricPostAcuteWoodmark](https://media.trabajo.org/img/noimg.jpg)
Provider Relations Specialist
2 months ago
Elderwood Independent Practice Association (IPA) is seeking an Provider Relations Specialist to join our incredible growing team of professionals. Why should you join Elderwood IPA? Monday-Friday Schedule w/ no weekends or overnights Hybrid working options Medical, Dental & Vision upon 1st of month following 60 days of hire Up to 140 hours (19 days) of PTO time PLUS six (6) holidays within the 1st year 401(k) retirement plan with vested employer match up to 4% Substantial Referral program Develops a network and conducts recruitment of new providers. Develops and maintains positive relationships with Elderwood Health Plan providers. Serves as a contact for providers and acts as a liaison between the providers and the company. Verifies and reviews provider applications and provider agreements for completion. Follows-up with providers and/or appropriate office staff regarding missing or expired information in the credentialing application. Maintains compliance by gathering credentials for contracted providers - obtains valid licenses, insurance documents, accreditations, and/or DEA certificates. Performs primary provider source verifications of license, malpractice history, and sanction activity through various web-based agencies and sources. Maintains provider credentialing files. Initiates contract negotiations and maintains current contracts and fee schedules. Maintains the PNDS files and prepares for quarterly network submission to the New York State Department of Health (NYSDOH); resolves any PNDS errors. Communicates with the NYSDOH regarding provider network data submission. Maintains and updates provider directories as needed. Maintain and updates provider manual as needed. Maintains provider information in the database; enters new information or change(s) to existing information. Distributes contracts, updates/letters, and any other needed documentation to providers. Performs provider orientations and ongoing provider education, including writing and updating orientation materials. Educates providers regarding policies and procedures related to referrals and claims submission. Investigates, resolves and communicates provider claim issues. Receives and effectively responds to external provider related issues. Accepts and processes incoming Provider Relations department calls. Provides support to Director of Business Development; assists with marketing initiatives as needed. Maintains current MLTCP product knowledge. Prioritizes and organizes work to meet deadlines. Travels as needed to providers’ offices. Provides training for other department specialists and/or coordinators as directed. Assists with future plan projects as directed. Utilizes electronic timekeeping system as directed. Arrives to work on time, regularly, and works as scheduled. Recognizes and follows the dress code of the facility including wearing name tag at all times. Follows policy and procedure regarding all electronic devices, computers, tablets, etc. Supports and abides by Elderwood IPA’s Mission, Vision, and Values. Abides by Elderwood IPA’s businesses code of conduct, compliance and HIPAA policies. Performs other duties as assigned by supervisor, management staff or Administrator. Minimum of Associate degree; Bachelor preferred Minimum of three (3) years of experience in a managed caresetting, medical office or facility setting with demonstration of medical administration duties Must be in good standing with the Medicare and Medicaidprograms Knowledge of contracts and revision process Knowledge of member service operations Current, valid driver license Demonstrated computer skills including Microsoft Office, e-mail systems, electronic medical records, and web-based programs Prior medical insurance experience, training and claims processing preferred This position requires regular interaction with residents, coworkers, visitors, and/or supervisors.In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
We have other current jobs related to this field that you can find below
-
Client Relations Specialist
1 month ago
Buffalo Grove, United States Alma Lasers Full timeAbout The Position Job Description Client Relations Specialist (CRS) 485 Half Day Rd. Ste 100 Summary As the first point of contact the Client Relations Specialist is to provide phone and email support to our customers. As a result of the Client Relations Specialist’s superior emotional intelligence skills, they will be able to deescalate tense situations...
-
Clinical Support Specialist
4 weeks ago
Buffalo, United States Kaleida Health Full timeUnder the direction of the Manager provides support for the team/branch in facilitating communications among internal and external contacts, maintenance of scheduling systems and other patient related information. Provides data entry support to the t Support Specialist, Clinical, Support, Specialist, Patient Services, Healthcare
-
Linkage Specialist
2 months ago
Buffalo, United States Evergreen Health Full timeJob DescriptionJob DescriptionCommunity Access Services The Linkage Specialist is responsible for the development, coordination, and implementation of linkage and navigation, and recruitment for HIV positive incarcerated men through the Criminal Justice Initiative. The Linkage Specialist also affiliates with representatives from ten (10) NYS correctional...
-
Payroll Specialist
3 weeks ago
Buffalo, United States Imagine Staffing Technology Full timeJob DescriptionJob DescriptionJob ProfileJob TitlePayroll Specialist LocationBuffalo, NYHire TypeContingent to HireSalary$50k - $55kWork ModelHybrid (after training)- 3 days/week from home!Contact Phone(716)-256-1289Contact Emailadugenske@imaginestaffing.net Nature & Scope:Positional OverviewLooking for an opportunity to showcase your expertise in as a...
-
Quality Assurance Specialist I
1 day ago
Buffalo, United States Lactalis American Group Full timeDescriptionMonday - Thursday - 10:00 am - 7:30 pm (4 hours on Sunday).Summary: The QA Specialist will assist the QA Manager in managing the flow of process deviation investigations and quality hold resolutions. As needed, the QA Specialist will support projects related to new or changing products. The QA Specialist will support, maintain and update...
-
Project Specialist
1 month ago
Buffalo, United States Lactalis American Group , Inc. Full timeLactalis American Group Inc. Project Specialist Buffalo , New York Apply Now Job Type Full-time Description Lactalis American Group is currently seeking candidates to join our Engineering team in Buffalo, NY. Lactalis, the world leader in dairy, is a family-owned business with more than 85,000 pragmatic and ambitious professionals worldwide, committed to...
-
Care Support Specialist
5 days ago
Buffalo, United States CINQCARE Full timeJob DescriptionJob DescriptionAbout CINQCARECINQCARE is a provider-led, community-based comprehensive health and care partner. Our purpose is to every day improve the health and well-being of those who need care the most. We do that by removing barriers to health and well-being and providing care in the community and as close to the home, including in-home,...
-
Care Support Specialist
5 days ago
Buffalo, United States CINQCARE Full timeJob DescriptionJob DescriptionAbout CINQCARECINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to Black and Brown communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in,...
-
Quality Assurance Specialist I
5 days ago
Buffalo, United States Select Division Career Page Full timeJob DescriptionJob DescriptionDescription:Monday - Thursday - 10:00 am - 7:30 pm (4 hours on Sunday).Summary: The QA Specialist will assist the QA Manager in managing the flow of process deviation investigations and quality hold resolutions. As needed, the QA Specialist will support projects related to new or changing products. The QA Specialist will...
-
Care Support Specialist
3 weeks ago
Buffalo, United States CINQCARE Full timeAbout CINQCARECINQCARE is a provider-led, community-based comprehensive health and care partner. Our purpose is to every day improve the health and well-being of those who need care the most. We do that by removing barriers to health and well-being and providing care in the community and as close to the home, including in-home, whenever possible.At CINQCARE,...
-
Insurance Authorization Specialist
4 days ago
Buffalo, United States Great Lakes Integrated Network, Inc. Full timeJob DescriptionJob DescriptionPosition Summary:The Insurance Authorization Specialist will provide daily onsite support at assigned hospital for support to the screening team. The insurance authorization specialist is responsible for updating the eligibility verification for patients admitting to facilities as well as submission of supporting documentation...
-
Assistant Engagement Specialist
3 weeks ago
Buffalo, United States City of New York Full timeThe New York County District Attorney's Office has an immediate opening for an Assistant Engagement Specialist in the Early Engagement Case Support Unit (EECU). In this position, the Assistant Engagement Specialist’s primary responsibility is to obtain signed supporting depositions from police officers and other law enforcement personnel. At the direction...
-
Care Support Specialist
3 weeks ago
Buffalo, United States CINQCARE Full timeJob DescriptionJob DescriptionAbout CINQCARECINQCARE is a provider-led, community-based comprehensive health and care partner. Our purpose is to every day improve the health and well-being of those who need care the most. We do that by removing barriers to health and well-being and providing care in the community and as close to the home, including in-home,...
-
Online Chat Specialist
4 weeks ago
Buffalo, United States Phoenix House Foundation Inc Full timeJob DescriptionJob DescriptionAn experienced issue solver to join our team as an Online Chat Specialist (Entry Level) is needed by our expanding company. We require a motivated person who can engage in online conversations with site visitors and respond to any queries they might have. Customers will receive prompt and accurate service from the chosen...
-
Project Specialist
1 month ago
Buffalo, United States Hiring Now! Full timeDescriptionLactalis American Group is currently seeking candidates to join our Engineering team in Buffalo, NY.Lactalis, the world leader in dairy, is a family-owned business with more than 85,000 pragmatic and ambitious professionals worldwide, committed to nurturing the future by providing healthy and delicious dairy products that bring people together...
-
Project Specialist
1 day ago
Buffalo, United States Lactalis American Group Full timeDescriptionLactalis American Group is currently seeking candidates to join our Engineering team in Buffalo, NY.Lactalis, the world leader in dairy, is a family-owned business with more than 85,000 pragmatic and ambitious professionals worldwide, committed to nurturing the future by providing healthy and delicious dairy products that bring people together...
-
Patient Relations Manager
1 month ago
Buffalo, United States Allergan Full timeObjective: Oversee all Patient Relations Management (PRM) activities in Belgium & Luxemburg, building strategic relationships with patient associations, advocating for patients' needs, driving patient-centric outreach programs, and ensuring compliance with relevant processes. Responsibilities: Develop strategic relationships with patient associations to...
-
HR Specialist II
1 month ago
Buffalo, United States Venture Forthe Full timeJob DescriptionJob DescriptionDescription:POSITION: HR Specialist II (Office & Clinical) Reference Number: HR001REPORT(S) TO: Director of HR STATUS: Non-ExemptREVISION: 4-2024POSITION SUMMARY:The HR Specialist (Office & Clinical) plays a pivotal role in managing the end-to-end recruitment process for both HCBS/Clinical and Office staff, ensuring compliance...
-
UKG Implementation Specialist
2 days ago
Buffalo, United States Robert Half Full timeJenny Bour with Robert Half is working with a growing organization that is looking for a UKG Implementation Specialist to join their team! As they continue to expand, they are seeking a talented UKG Implementation Specialist to join the team and play a crucial role in the successful deployment of UKG systems across their client base. The UKG Implementation...
-
UKG Implementation Specialist
2 days ago
Buffalo, United States Robert Half Full timeJenny Bour with Robert Half is working with a growing organization that is looking for a UKG Implementation Specialist to join their team! As they continue to expand, they are seeking a talented UKG Implementation Specialist to join the team and play a crucial role in the successful deployment of UKG systems across their client base. The UKG Implementation...