Healthcare Provider Relations Coordinator

2 weeks ago

Texarkana, Texas, United States Christus Health Full time

Overview:

The Physician Relations Specialist I is accountable for overseeing the administrative and operational functions associated with the daily activities of the Physician Hospital Organization (PHO). This role encompasses healthcare contracting, provider relations—both financially and operationally—payor relations, network expansion, and various related responsibilities for contracted health plans, executed independently and under the guidance of the Executive Director. The position also involves the maintenance and ongoing enhancement of centralized facility credentialing within the CHRISTUS Health System Managed Care Department. Responsibilities will include provider education, database management, marketing initiatives, and support with provider credentialing and certification as necessary.

Key Responsibilities:

  • Facilitates network expansion through provider education, service promotion, and office orientations via on-site meetings and diverse communication methods.
  • Drives network development through contract rate negotiations and processing.
  • Acts as the primary liaison for providers regarding all network-related inquiries, whether from the provider/physician side or the client company side.
  • Delivers exceptional, prompt customer service with an emphasis on provider retention, ensuring satisfaction and utilization of the network among providers, clients, brokers, consultants, and third-party administrators.
  • Supports Board of Directors meetings, Credentialing Committee meetings, and other network sales meetings as required.
  • Assists in the credentialing and recredentialing processes.
  • Performs additional duties as assigned.
  • Possesses comprehensive knowledge of PHO contracts and reimbursement methodologies across all areas to provide support to physicians and healthcare provider office staff.
  • Maintains a thorough understanding of various managed care contracts, including but not limited to plan types, networks, contracted reimbursements, claims issues, and physician loading procedures.
  • Informs provider offices of new contracts and modifications to existing contracts. Updates contracted health plans and select payors on changes in key provider information to ensure accurate records and claims processing.
  • Assists in updating payor network rosters, directories, and matrices as necessary to maintain precise participation records. Verifies and requests written notifications when required by health plans or payors.
  • Fosters a positive attitude and collaborative relationship with PHO physicians and contracted payors to address operational challenges and concerns.
  • Schedules and coordinates committee and board meetings as requested.
  • Documents committee meetings with detailed minutes and produces final minutes in a timely manner as requested.
  • Conducts provider education in accordance with the relevant requirements of each plan, including the development of provider manuals and newsletters, as well as the assessment and delivery of appropriate training.
  • Organizes and facilitates regular meetings of the Office Advisory Committee, which consists of key physician office staff, to provide an open forum for discussions on contracts, claims issues, current news, and updates.
  • Prepares quarterly accounting invoices, manages daily bank deposits, maintains accurate accounting records, and performs other accounting duties as necessary.
  • Contributes to the overall administrative efforts of the PHO office as requested.
  • Collaborates closely with PHO staff.

Qualifications:

Education/Skills:

  • Bachelor's Degree required.
  • Proficient computer skills and typing ability.
  • Strong organizational, interpersonal, and verbal/written communication skills are essential.
  • Ability to work independently with minimal supervision.

Experience:

  • Two to five years of clerical experience, preferably in a hospital setting or equivalent.

Licenses, Registrations, or Certifications:

  • No specific licenses required.

Work Type:

Full Time

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