Provider Relations Representative

Description:

POSITION SUMMARY:

 

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.

 

KNOWLEDGE/SKILLS/ABILITIES:

  • 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

 

CLICK HERE TO APPLY

 

 


We are an Equal Opportunity Employer.


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Advanced Behavioral Health, Inc.

213 Court Street
Middletown, CT 06457

Phone: (860) 638-5309
Fax: (860) 638-5302