Provider Relations Representative jobs in New Suffolk, NY

Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Provider Relations Manager
  • Vytalize Health
  • Smithtown, NY FULL_TIME
  • Your Opportunity

    As our Provider Relations Manager, you play a critical role in steering the national Provider Relations department towards excellence. Your responsibilities encompass hiring, training, coaching, and assessing the performance of the Provider Relations staff, ensuring they are aligned with our mission and values. You are pivotal in facilitating team development with a focus on collaboration and process refinement, crafting and upholding policies, processes, and procedures to meet both internal and external standards. Your leadership ensures our Provider Relations team delivers a customer-centric experience, fostering strong relationships with providers, enhancing retention, and continuously improving our service quality. Your strategic insight into provider interactions, your ability to identify service enhancement opportunities, and your leadership in strategic initiatives are invaluable in our pursuit of organizational excellence.

    What You Will Do

    • Responsible for the national Provider Relations department.
    • Hires, trains, coaches, and evaluates the performance of the Provider Relations staff.
    • Facilitates individual and team development focused on collaboration and process improvement.
    • Develops and maintains policies, processes, and procedures to meet internal and external standards and ensures staff adhere to standard operating procedures.
    • Leads the Provider Relations team in creating a customer-focused, provider experience by listening to the customer and providing timely, clear, and consistent communication.
    • Create customer loyalty and improve retention by building strong relationships with providers by setting reasonable expectations, addressing issues timely, and delivering exceptional service aligned with Vytalize values.
    • Create a journey map of the providers’ interactions with the organization to evaluate different user scenarios and identify gaps.
    • Measures and reports on operational performance, identifies trends, and implements preventive actions.
    • Conducts internal routine audits and implements appropriate action.
    • Delivers strategic communications to providers.
    • Coordinates escalated claim disputes and all necessary research in a timely and effective way.
    • Coordinates root cause analysis of issue resolution.
    • Develops and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards.
    • Oversees appropriate and timely intervention/communication when providers have issues or complaints (e.g., problems with claims, roster participation, credentialing, reimbursement methodologies, and provider website).
    • Drive focused strategic outreach with Providers to support Vytalize organizational initiative

    What will make you successful here

    • Strong communication, organizational, and time management skills.
    • Proficient in relationship management and customer service.
    • Expertise in root cause analysis and complex issue resolution.
    • Knowledge of Value-Based and ACO payment methodologies.
    • Familiarity with credentialing processes and payer/ACO roster management.
    • Experience with Medicare Fee-for-Service, ACO REACH, MSSP, and Commercial/Medicare Advantage programs.
    • Excellent communication, leadership, and problem-solving skills.
    • Demonstrated ability to drive organizational growth and meet operational goals.
    • Financial acumen with experience in budget management and reporting.
    • Current awareness of healthcare industry trends and regulatory changes.
    • Entrepreneurial spirit, a sense of ownership and comfortable operating in ambiguity
    • Solution oriented with the ability to think strategically and creatively in decision-making
    • Strong work ethic to exceed expectations and goals
    • Coachable and able to take direction and feedback well, yet being forward-thinking to challenge the status quo
    • Ability to act with integrity, professionalism, and confidentiality.
    • Proficient with Microsoft Office Suite or related software.

    Perks/Benefits

    • Competitive base compensation
    • Annual bonus potential
    • Health benefits effective on start date; 100% coverage for base plan, up to 90% coverage on all other plans for individuals and families
    • Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
    • 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
    • Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days
    • Company paid STD/LTD
    • Technology setup
    • Ability to help build a market leader in value-based healthcare at a rapidly growing organization

    Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com

    Job Type: Full-time

    Pay: $80,000.00 - $100,000.00 per year

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Professional development assistance
    • Retirement plan
    • Vision insurance

    Schedule:

    • 8 hour shift

    Ability to Relocate:

    • Smithtown, NY 11787: Relocate before starting work (Required)

    Work Location: Hybrid remote in Smithtown, NY 11787

  • 7 Days Ago

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Customer Relations Representative
  • Tekweld
  • Hauppauge, NY FULL_TIME
  • Department: Client Relations Position: Customer Service Representative Job Type: Full Time Job Description: We are hiring a Client Relations Representative to establish and maintain quality assurance ...
  • 4 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • James Grossi - State Farm Agent
  • Southampton, NY FULL_TIME
  • Position Overview Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the ...
  • 18 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Joe Aguirre - State Farm Agent
  • Smithtown, NY FULL_TIME
  • Position Overview Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Customer Relations Representative - State Farm Agent Team Member. We seek a...
  • 18 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Steve Klinzing - State Farm Agent
  • Patchogue, NY FULL_TIME
  • Benefits: Bonus based on performance Competitive salary Opportunity for advancement Paid time off Training & development ROLE DESCRIPTION: As a Customer Relations Representative - State Farm Agent Tea...
  • 19 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Steven Pescetti - State Farm Agent
  • Mastic, NY FULL_TIME
  • Position Overview Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the ...
  • 19 Days Ago

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0 Provider Relations Representative jobs found in New Suffolk, NY area

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Patient Access Representative - Emergency Room (7pm -3am)
  • Stony Brook Medicine
  • Stony Brook, NY
  • Position Summary At Stony Brook Medicine, our Patient Access Representatives are responsible for completing varied, dive...
  • 3/28/2024 12:00:00 AM

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Customer Service Associate (Bilingual)
  • Public Service Enterprise Group
  • Melville, NY
  • Requisition: 77445 PSEG Company: PSEG Long Island Salary Range: $ 21.03 - $ 26.77 Incentive: Not applicable Work Locatio...
  • 3/28/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • West Babylon, NY
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/27/2024 12:00:00 AM

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Contact Center - Member Services Representative - PT
  • Suffolk Federal Credit Union
  • Islandia, NY
  • Join our Member Services Team as a Member Services Representative in our Contact Center and start enjoying all of the be...
  • 3/27/2024 12:00:00 AM

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Customer Service Representative
  • Prestige
  • Melville, NY
  • WE ARE HIRING ASAP! LOCAL CUSTOMER SERVICE APPLICANTS NEEDED! We are looking for someone with excellent communication sk...
  • 3/27/2024 12:00:00 AM

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FT Customer Service Representative - Work From Home>
  • Dick's Sporting Goods, Inc.
  • Riverhead, NY
  • [Customer Support / Remote] - Anywhere in U.S. / Up to $46.2K per year / Benefits - As a Customer Service Rep you'll: As...
  • 3/27/2024 12:00:00 AM

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Contact Center - Member Services Representative - PT
  • Suffolk Federal Credit Union
  • Riverhead, NY
  • Join our Member Services Team as a Member Services Representative in our Contact Center and start enjoying all of the be...
  • 3/27/2024 12:00:00 AM

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Hospital Attendant - OR Full-time Evening Shift
  • Stony Brook Medicine
  • Stony Brook, NY
  • Position Summary At Stony Brook Medicine, our Hospital Attendants are valuable members of our team, whoprovide routine c...
  • 3/26/2024 12:00:00 AM

New Suffolk is a census-designated place (CDP) that roughly corresponds to the hamlet by the same name in the Town of Southold in Suffolk County, New York, United States. The CDP's population was 349 at the 2010 census. According to the United States Census Bureau, the hamlet has a total area 0.62 square miles (1.6 km2), of which 0.54 square miles (1.4 km2) is land and 0.04 square miles (0.1 km2), or 8.83%, is water....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$57,947 to $74,132
New Suffolk, New York area prices
were up 1.6% from a year ago