Provider Relations Representative I

Summary Description:

The Provider Relations Representative I works in close collaboration with internal departments to input and maintain up-to-date provider data and provide reporting on provider data. The Provider Relations Representative I provides complaint resolution, responds to inquiries, and assists with provider data related issues.

Representative Duties:

• Add, update, and maintain provider data in accordance with internal policies and procedures.

• Investigate and resolve identified provider data issues as they arise.

• Update and maintain required provider reports.

• Provide medical providers and administrators access to online eligibility verification.

• Process applications, requests for access, and the assignment/management of usernames and passwords.

• Perform testing of Facets Application Software as requested.

• Produce provider directories as requested.

• Lead, participate, and maintain assigned surveys.

• Perform other duties and special projects as assigned

Qualifications:

• Associate Degree in Business Administration or a related discipline.

• 2 years’ related experience in the healthcare industry, preferably HMO.

• Experience working with Facets Application Software is a plus.

• Intermediate computer skills, including electronic mail, routine database activity, word processing, spreadsheet, graphics, etc.

• Must be able to speak, read, write, and understand the primary language(s) used in the workplace

Salary:

$20.00 to $23.00 Hourly

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.