Health Care Service Corporation logo
Health Care Service Corporation

Empowering Whole Person Health With Compassion and Innovation

Provider Relations Representative

Location

Tennessee + 1 moreAll locations: Tennessee | Texas

Posted

1 day ago

Salary

$55.9K - $123.5K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Provider Relations Representative

Health Care Service Corporation

• Responsible for the contracting, credentialing, and maintenance of professional provider data to support marketing, membership and network contracting across all lines of business. • Building relations with the provider community. • Promoting high quality initiatives to support data integrity. • Accepting ownership and leading highly specialized operational and customer support duties that require independent initiative. • Participating in internal provider meetings and work groups. • Researching problems related to provider credentialing, data and network participation. • Providing training and education to all Blue Cross contracted providers including hospitals, physicians, and other allied professional providers.

Job Requirements

  • Bachelor’s Degree and three (3) years of work experience in managed care OR a minimum of five (5) years work experience in a managed care environment.
  • Two (2) years of healthcare administration experience in clinical and financial settings, with direct provider communication experience.
  • Effective interpersonal, analytical, presentation and communication skills.
  • Knowledge of the healthcare industry, healthcare systems and payer/provider dynamics.
  • Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
  • Strong comprehension of contracts, applications, and products.
  • Understanding of provider reimbursement methodologies and claims.
  • Working knowledge of claims processing systems.
  • Effective organizational and planning skills with the ability to take initiative and work independently.
  • Demonstrated ability to meet deadlines and work well under pressure.
  • Clear and concise interpersonal, verbal and written communication skills.
  • Collaboration skills resulting in business/process improvements/changes.
  • PC proficiency and skills to include Word, Excel, PowerPoint, etc.
  • Strong facilitation, presentation and analytical skills.

Benefits

  • Health and wellness benefits
  • 401(k) savings plan
  • Pension plan
  • Paid time off
  • Paid parental leave
  • Disability insurance
  • Supplemental life insurance
  • Employee assistance program
  • Paid holidays
  • Tuition reimbursement

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