Provider Relations Specialist

Position Code: 67

Department:  Provider Relations
Location: Little Rock, Arkansas
Immediate Supervisor:  Pamela Waters
Status: Non-Exempt
Posted: May 17 2017

Essential Functions of Job:

• Preparation and maintenance of a provider file for the Credentialing/Recredentialing process • Review and preparation of file for referral to primary source verification company • Respond inquires in the Provider Relations email in-box • Upon receipt of provider file from primary source verification company, assist with preparation of file for presentation at monthly credentialing committee • Prepare and maintain Provider Directory • Call on providers to verify information and obtain current DEA, DPS licenses and proof of Professional Liability Insurance • Assist the Provider Maintenance and re-pricing Departments • Assist with implementation of database changes and maintenance to include new license and proof of liability insurance expiration dates as well as updating next recredentialing date • General clerical duties, to include but limited to filing, answer and screen incoming telephone calls, generating correspondence and scanning of documents • Scan all current copies of licenses and proof of liability insurance, all credentialing/recredentialing documents, all Aperture primary verification documents, all executed contracts • Assist in provider workshops • Assist in health fairs • Assist in member educational workshops • Ability to report to the office

Qualifications:

• High school diploma or equivalent • Effective organizational and prioritization skills • Excellent oral and written communication skills • Basic knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access) • Ability to work in a fast paced multi-tasking environment • Strong interpersonal skills with ability to function as a positive team member • Working knowledge of CPT-4 coding, ICD9 and medical terminology a plus

 

The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.

Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.

Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.