Provider Relations Representative

Blue Cross of Idaho (BCI) is seeking a Provider Relations Representative to act as a primary liaison between the organization and healthcare providers. In this independent role, you will maintain open communication regarding provider policies and payment procedures while training and education providers on BCI contact requirements and operational procedures.

We are looking for a Provider Relations Rep with:

Provider Relations Rep I:

• Experience: 4 years' provider service or health industry experience
• Education: High School or equivalent

Provider Relations Rep II:

• Experience: 8 years' provider service or health industry experience
• Education: High School or equivalent

What your day may look like:

• Coordinates the resolution of provider contracts, agreements, fee schedules, and payment problems.
• Collaborates with key stakeholders to identify and resolve issues.
• Coordinate’s resolution of contract or agreement issues. Communicates critical issues and provides recommendations to leaders.
• Educates providers on policies, procedures, practices, and data integrity. Ensures providers are informed on changes/updates to policies, procedures, and practices.
• Ensures department and provider compliance with regulatory agencies.
• Coordinates cross departmental activities and projects to support and adhere to the provider contract requirements.
• Performs research to respond to inquiries and interprets policy and procedures to determine effective response.
• Provides welcome information to newly contracted providers.
• Promotes provider participation in on-line tools and programs available.
• Performs other duties and responsibilities as assigned.

As of the date of this posting, a good faith estimate of the current pay range is $26.12 to $31.90. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.