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