Provider Relations Coordinator (Remote)
Company: Kepro
Location: Fort Lauderdale
Posted on: June 22, 2022
Job Description:
Provider Relations Coordinator
- Are you an experienced Provider Relations Coordinator looking
for a new challenge?
- Do you value care management and quality improvement?
- Are you motivated, energetic, and excited to become part of the
Kepro team?If so, you might be our next new team member!Who we
need:The Provider Relations Coordinator performs duties to
coordinate, negotiate and handle activities of the provider
contracting and provider relations/services function, including
recruitment and contract negotiations. This position will also
provide administrative support to our Credentialing department as
well as serve as the liaison to providers.Why us?Kepro is a rapidly
growing national quality improvement and care management
organization. We work to ensure that over 20 million people receive
the right care, at the right time, in the right setting.People
Focused. Mission Driven.Shape the future of healthcare with us. We
are mission driven to improve lives through healthcare quality and
clinical expertise.We do this through our people.At Kepro, you can
do meaningful work that makes a real difference for the lives of
individuals across the country. We are an organization that cares
deeply about our employees and we provide the training and support
to do the best work of your career.Benefits are a key component of
your rewards package at Kepro. These benefits are designed to
provide you and your family additional protection, security, and
support for both your career and your life away from work. They are
comprehensive and fit a variety of needs and situations. Our
benefits include comprehensive health plans, paid time off,
retirement savings, corporate wellness, educational assistance,
corporate discounts and more.What you'll do:
- Research cites/regions to identify potential providers using
various sources; state mental health provider list, insurance
plans, licensure boards, etc.
- Conduct provider outreach via phone, email or USPS mail.
- Track provider responses and location coverage by
percentage.
- Ability to explain the Kepro credentialing process and answer
any questions potential providers have regarding credentialing
documents.
- Coordinates with Credentialing department to ensure that all
credentialing documents are completed correctly and returned in a
timely manner
- Recruits and retains practitioners and provider
organizations.
- Reviews and prepares both the practitioner and provider
organization contracts for in network and out of network (single
case agreements).
- Handles data entry of network information and provides
administrative support to the Credentialing department.
- Serves as the Liaison for resolution of practitioner/provider
issues during the credentialing process.
- Monitors network access to measure accessibility.
- Prepares client reports related to the network.
- Follow-ups - Manages a daily Follow-up Report, places outreach
calls to 100% of clients on date of scheduled follow-up to assure
connection with services; completes telephonic surveys per
protocol; completes steps necessary to connect clients to desired
services.
- Appointment Setting Requests - Responds real-time to EAP
Consultants requests for appointments setting on behalf of clients;
conducts outreach to network providers to determine availability
for new clients; communicates basic information to providers; and
contacts clients to confirm appointments.
- Phone Queue - Assists with incoming calls from clients and
network providers; responds to inquiries regarding client benefits,
procedures, paperwork, payment and other questions; collaborates
with Provider Relations department as needed to resolve provider
inquiries; and retrieves and follows up on provider inquires left
in voicemail box per established workflows. Assists with
recruitment and other network reports as needed.
- Vouchers - Issues and sends payment vouchers to network
providers in accordance with KEPRO policy and procedures and as
directed by contracts.
- Data Entry - Maintains accurate client records in database by
entering all calls, case updates, requests, and referrals accepted
by clients per KEPRO policy. As part of a customer service e-mail
distribution list, enters referrals provided to clients by KEPRO
partners into database.
- Other duties as assigned in order to assist internal and
external customers in achieving EAP departmental goals.The list of
accountabilities is not intended to be all-inclusive and may be
expanded to include other duties that management may deem necessary
from time to time.What you'll need:Required Qualifications
- High school diploma or equivalent required. Bachelor's Degree
preferredKnowledge, Skills, Abilities
- Proficiency with typing and data entry.
- Knowledge of provider relations.
- Knowledge of NCQA and URAC standards.
- Proficiency with Microsoft Office suite (Outlook, Word, Excel,
PowerPoint, and SharePoint)
- Ability to explain the Kepro credentialing process and
documents to potential providers.
- Excellent organizational, verbal, written communication,
negotiation, and customer service skills.
- Ability to handle confidential business information and PHI
with discretion.
- Ability to effectively manage several tasks at once and meet
deadlines
- Strong analytic problem-solving abilities.
- Strong attention to detail and organizational skills.
- Strong interpersonal skills in order to work as an effective
part of a team
- Ability to read and interpret benefits and account information
pertaining to customized products
- Self-starter with the drive to stay on task in a fast-paced
environment, multitasker
- Bilingual Spanish-English a plus.
- Ability to problem-solve, exercise judgment, and make decisions
independentlyExperience
- Minimum of two years customer service experience.
- Some call center experience is highly preferred.
- Previous provider relations experience preferred.Thank You!We
know your time is valuable and we thank you in advance for applying
for this position. Due to the high volume of applicants we receive,
only those who are chosen to advance in our interview process will
be contacted. We sincerely appreciate your interest in Kepro and
invite you to apply to future openings that may be of interest.
Best of luck in your search!- The Kepro Talent Acquisition
TeamMental and Physical RequirementsThe physical demands described
here are representative of those that must be met by an employee to
successfully perform the essential functions of this job.
Reasonable accommodations will be made as required by law in an
attempt to enable an individual with a disability to perform the
essential functions of this job. While performing the duties of
this job, the employee is regularly required to sit for prolonged
periods of time; key and/or control objects; interact extensively
with internal and external customers; occasionally lift and/or move
objects weighing up to 10 pounds; and occasionally travel within
the state.EOE AA M/F/Vet/DisabilityKepro is an Equal Opportunity
Employer. All qualified applicants will receive consideration for
employment without regard to race, color, religion, sex, sexual
orientation, gender identity, national origin, disability, or
status as a protected veteran.
Keywords: Kepro, Fort Lauderdale , Provider Relations Coordinator (Remote), Other , Fort Lauderdale, Florida
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