Provider Relations Manager jobs in Abbottstown, PA

Hours: M-F Day

Full time: 40 hours/week

General Summary

Develops and maintains relationships with healthcare providers. Explains the Plan's policies, procedures, and protocols to providers, and resolves providers' concerns and problems.

Essential Functions:

• Develops and maintains ongoing communication with providers, practice manager, and office staff representatives.
• Resolves provider's concerns and problems related to policies, procedures and protocols, the provider network and other related issues.
• Maintains confidentiality of provider information.
• Maintains up to date provider information required to meet Plan certification criteria.
• Forwards appropriate provider, and/or billing information to others to build out in our claims processing and credentialing systems.
• Assists in resolving claim issues.
• Runs reports as needed to ensure data quality and appropriate billing standards are met.
• Assists with preparing letter of agreements, single case agreements, and contracts as needed.

Travel Requirements:

• Estimated Amount: - Travel may be required.

Qualifications

Minimum Education:

• High School Diploma or GED Required
• Associates Degree Preferred

Work Experience:

• 2 years credentialing or provider relations experience required
• Claims experience preferred
• Epic experience would be a plus
• Great collaboration and organizational skills preferred
• Must have strong attention to detail

Courses and Training:

• Behavioral Health terminology. Required and
• AMA CPT-4 Coding Guidelines. Upon Hire Required and
• ICD-10 coding. Upon Hire Required

Knowledge, Skills, and Abilities:

• Ability to multi-task.
• Works independently by prioritizing workload.
• High level of organizational skills.
• Proficiency in data entry.
• Excellent communications/interpersonal and computer skills.