Provider Relations Coordinator (Remote U.S.) Full Time

Summary

The Provider Relations Coordinator (Remote U.S.) at Acentra Health, LLC focuses on provider contract coordination and recruitment. Acentra Health, a leader in health solutions, leverages technology and expertise to improve outcomes, offering a supportive, innovative environment for career growth.

Responsibilities

• Research and analyze geographic areas to identify potential healthcare providers through comprehensive exploration of sources such as state mental health provider lists, insurance plans, and licensure boards.
• Initiate effective outreach to potential providers using various communication channels, including phone, email, and USPS mail.
• Systematically track and document provider responses, assessing geographical coverage by percentage.
• Demonstrate expertise in articulating the Acentra Health credentialing process, providing comprehensive information, and addressing queries from potential providers regarding credentialing documents.
• Collaborate seamlessly with the Credentialing department to ensure accurate and timely completion of all credentialing documents.
• Drive recruitment and retention efforts for practitioners and provider organizations.
• Thoroughly review and prepare contracts for both practitioners and provider organizations, encompassing in-network and out-of-network agreements, including single-case agreements.
• Efficiently handle data entry tasks related to network information and contribute administrative support to the Credentialing department.
• Serve as a liaison for resolving practitioner/provider issues during the credentialing process.
• Closely monitor network access to gauge and enhance accessibility.
• Generate client reports pertaining to the network and ensure their accuracy and relevance.
• Manage a daily Follow-up Report, conducting outreach calls to all clients on the scheduled follow-up date to ensure seamless connection to services; conduct telephonic surveys as per protocol.
• Respond promptly to appointment setting requests from EAP Consultants, coordinating with network providers to determine availability for new clients, communicating essential information to providers, and confirming appointments with clients.
• Efficiently handle incoming calls from clients and network providers, addressing inquiries related to client benefits, procedures, paperwork, payments, and other questions.
• Collaborate with the Provider Relations department as needed to resolve provider inquiries.
• Proactively manage the phone queue, responding to inquiries and following up on provider inquiries left in the voicemail box according to established workflows.
• Issue and send payment vouchers to network providers in strict adherence to Acentra Health policies and procedures, as directed by contracts.
• Maintain precise client records in the database by diligently entering all calls, case updates, requests, and referrals accepted by clients, following Acentra Health policies.
• Enter referrals provided to clients by Acentra Health partners into the database as part of a customer service email distribution list.
• Other duties as assigned to help internal and external customers achieve EAP departmental goals.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Requirements

• Education: A minimum of a High School Diploma OR GED equivalent (or higher level of education).
• Customer Service Skills: 2+ years excellent customer service skills, in a coordinator role, preferably within the healthcare industry.
• Technical Skills: Intermediate proficiency with Microsoft Office Word, Excel, and Beginner proficiency with and PowerPoint, Outlook, Teams, and SharePoint.
• Education: Bachelor’s Degree (preferred).
• Typing and Data Entry: Proficient.
• Communication: Exceptional organizational, verbal, and written communication skills.
• Negotiation and Customer Service: Strong abilities.
• Confidentiality: Capable of handling confidential business information and Protected Health Information (PHI) with discretion.
• Multitasking: Effective multitasking with the ability to manage several tasks simultaneously and meet deadlines.
• Problem-Solving: Strong analytical problem-solving skills.
• Attention to Detail: High attention to detail and organizational proficiency.
• Interpersonal Skills: Excellent for effective teamwork.
• Reading and Interpretation: Proficient in reading and interpreting benefits and account information related to customized products.
• Decision-Making: Ability to problem-solve, exercise judgment, and make independent decisions.
• Work Ethic: Self-starter with a strong work ethic, capable of staying focused in a fast-paced environment.
• Language Proficiency: Bilingual proficiency in Spanish and English.

Benefits

• Health insurance.
• Paid time off.
• Tuition reimbursement.
• Comprehensive health plans.
• Retirement savings.
• Corporate wellness.
• Educational assistance.
• Corporate discounts.