Provider Services Coordinator I
2 weeks ago
Karmanos Cancer Institute is a leading health organization dedicated to delivering high-quality, evidence-based care to patients. Our network encompasses a variety of facilities and services, including hospitals, outpatient centers, and specialized care providers.
As a part of our mission, we are committed to enhancing the health and well-being of the communities we serve through comprehensive cancer care and support.
Position Overview:
We are seeking a Provider Relations Specialist I to join our dynamic team. This role is crucial in fostering relationships with healthcare providers and ensuring they are well-informed about our services and policies.
The Provider Relations Specialist I will be responsible for:
- Educating and supporting assigned provider groups on all aspects of our health plan and its subsidiaries.
- Assisting in the creation of policies, procedures, and educational resources for Provider Programs.
- Developing benchmarks to evaluate performance against organizational goals.
- Building and maintaining effective relationships with key healthcare professionals and their office staff.
- Managing the contracting process for primary care physicians, specialists, and ancillary providers within the designated service area.
- Conducting claims research and facilitating resolution.
This position is fully remote, allowing for flexibility while contributing to our mission.
Equal Opportunity Employer:
Karmanos Cancer Institute is proud to be an Equal Opportunity Employer, welcoming applicants from diverse backgrounds.
Qualifications:
Required:
- High School Diploma or GED.
- A minimum of two years of experience in HMO, PPO, TPA, PHO, or Managed Care claims operations or provider billing functions.
- Valid state driver's license, reliable transportation, and automobile insurance coverage.
OR
- An equivalent combination of two years of college coursework and relevant experience in Managed Care claims operations or provider billing functions.
Preferred:
- Associate degree in business, healthcare, or a related field.
- Two years of experience in contracting or servicing healthcare providers and their office staff.
- Established relationships with providers in the service areas.
Schedule:
Full-time position with standard working hours.
Requisition ID:
Daily Work Times: 8:00 am - 5:00 pm
On Call:
No
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