The Provider Relations Representative supports the credentialing and provider relations services for the Behavioral Health Home Program. The Provider Relations Representative works collaboratively with providers and fosters a positive perception of the contract among providers. This position will represent ABH and its services in a positive and professional manner and adhere to ABH’s best practices, guidelines, policies and procedures as established, promoting ABH as a leader in behavioral healthcare in all interactions and work.
DUTIES AND RESPONSIBILITIES:
- Communicates with all providers in a professional and respectful manner, promoting positive provider practices through communication and mutual education;
- Provides administrative services of provider contract in the most efficient manner possible in an effort to reduce administrative burden on providers;
- Provides support/service to providers including orientation and education of providers and staff and incorporating contract policies and procedures;
- Acts as liaison with other departments in the company regarding provider issues;
- Assists in the research of information regarding provider issues/operations;
- Tracks and manages all inquiries, complaints and/or grievances consistent with ABH Policy, including notification of the BHHP Program Manager;
- Assists in Provider Orientation Sessions and ongoing technical assistance visits as determined by the BHHP Program Manager;
- Assist the BHHP Program Manager in monitoring provider performance
- Proactively identifies opportunities to improve the provider's understanding of proper billing and posting procedures;
- Assists in provider credentialing/re-credentialing processes, including but not limited to preparation and mailing/emailing of credentialing documents, review of returned documents, performance of primary source verification, and documentation of credentialing information in the electronic data systems;
- Maintains confidentiality of all client protected health information and adheres to all HIPAA related policies and procedures;
- Performs other tasks/responsibilities as required to support the business operations;
- Demonstrates ethical behavior and cultural sensitivity in all activities involving individuals of diverse background.
EDUCATION AND EXPERIENCE REQUIREMENTS:
- Associate’s Degree required;
- Bachelor's degree in Health Sciences or related field preferred;
- Minimum of two years provider relations experience in health insurance industry, preferably behavioral health;
- Attends annual conflict of interest training.
- The ability to work independently, flexible in order to respond quickly and positively to shifting demands;
- Demonstrates exceptional interpersonal skills in order to positively communicate with providers and staff;
- Occasional travel required;
- Strong attention to detail; ability to work on multiple tasks and meet deadlines;
- Excellent PC skills with demonstrated experience using Microsoft Office Package (MS Word, Excel, Power Point, Access, Outlook); internet
- Strong written and verbal communication skills required.
If your qualifications match these job requirements and you are interested in pursuing this potential position and joining a dynamic company, please apply on-line at www.abhct.com. include resume, letter of interest and salary requirements/range.
ABH® is an Equal Opportunity Employer