City
Columbia
State
SC
Job Type
Full-Time Regular
Date Posted
12/14/2023
 
Compensation
5-10% bonus
Job Description

Flybridge Staffing is currently searching for a Healthcare Provider Consultant for a client in the Columbia South Carolina area. This person must be highly proficient and creative at identifying and solving problems. You must be able to work independently as a telecommuter and require daily local travel/visits to different healthcare facilities in your area.

Responsibilities:

  • Serve as the primary liaison between The Healthcare Network and the participating provider community who service our members in multiple product lines throughout the state of South Carolina. (primarily centralized to Columbia)
  • Build and maintain strong relationships with providers by offering excellent customer service to assigned primary care, and specialty care physicians with routine and targeted education visits for the purpose of continued education regarding policies/initiatives. Service also includes supply deliveries and prompt follow up regarding claims, benefits and procedural guidelines for authorization of services.
  • Conduct on-site visits, telephone conversations and written communications with individuals including Hospital executives, Patient Account Managers, Physicians, Office and Billing Managers.
  • Perform on-site provider orientations and group county orientations for new primary care, and specialty care physicians regarding policies, procedures, billing, and company-wide initiatives.
  • Consults with physician offices to develop training curriculum specific to client process and work flow for optimal use and operation of EHR systems.
  • Analyzes workflow by observing customer operations for three days and configures system to the customer’s workflow.
  • Maps customer’s data from current system to new EHR system.
  • Represent the Provider Relations Department and Practice Transformation Specialist in work groups and committees that address both internal and external customer concerns regarding the operations of The Healthcare Network as it pertains to the provider community.\

Minimum Qualifications:

  • 2 years’ experience required in Provider Relations and/or Managed Care Product Administration

Preferred Qualifications:

  • Bachelor’s degree in Business Administration, Marketing, Health Care Administration or Other Related Degree
  • 2 years’ Provider Relations experience or medical office or hospital experience
  • 2 years’ exposure to medical claims processing procedures
  • Knowledge and understanding of the dynamics of Managed Care environment, including capitation and reimbursement structure

Essential Job Functions:

  • Communicate effectively as a liaison between the provider community and Advanced Management in order to provide education on policies and procedures as well as, to assist in the resolution of issues or concerns a provider may have.
  • Provider Orientations: Perform on-site provider orientations for primary care, specialty care physicians regarding policies, procedures, billing and company-wide initiatives within 30 days of becoming credentialed and approved.
  • Oversee group county provider orientations by determining location, arranging for mailing of invitations and make available at the presentation of corporate forms, QI Manuals, directories and the Advanced Management Provider Office Policy and Procedure Manual, as needed.
  • Goal/Target Visits: Service primary care, and specialty care physicians within a specific geographic territory by conducting annual Goal / Target visits for the purpose of continued education regarding policies/initiatives. Each Provider Relations Representative will schedule minimally one goal visit per year with participating practices in the following specialties: Primary Care / Specialists

****NO SPONSORSHIP AVAILABLE**** US Citizen, GC, EAD only please. If your background aligns with the above details and you would like to learn more, please submit your resume to jobs@flybridgestaffing.com or on our website, www.flybridgestaffing.com and one of our recruiters will be in touch with you ASAP.

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