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Representative-Provider Relations - HS Provider Relations Corporate

Job ID: 8281
Job Category: Administrative Non Clinical Support
Job Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Facility: BMHCC Corporate Office
Location: Memphis, TN

Summary

Participates in all appropriate aspects of development of BHSG networks and products to ensure the network of healthcare providers meets customer quality, access, and cost requirements. Acts as a liaison between the provider and the various health plans and/or payers. Performs provider orientations and delivers ongoing education in order to develop and maintain rapport with the providers and support staffs and to enable problem-solving and contract compliance. Performs other duties as assigned.

Responsibilities

  • Maintains working knowledge of BHSG provider contracts, fee schedules and health plan requirements to respond to customer needs regarding network issues.
  • Promotes retention of providers in the network through ongoing education, problem solving and resolution of provider grievances in order to promote accessible patient care and adherence to the health plan requirements.
  • Receives provider inquiries, answers questions, interprets provider contracts, fee schedules, and health plan requirements, and solves payer-provider issues in a timely manner consistent with good customer service/relations.
  • Makes recommendations and provides support and assistance, both internally and externally, in the interpretation of multiple fee schedules, utilizing computer resources and technology to accomplish objectives.
  • Completes assigned goals.


Requirements, Preferences and Experience

Education

Minimum: Bachelor's degree in health administration, marketing, or related field or equivalent experience.

Experience

Preferred: 4 years managed care experience.

Minimum: 3-5 years customer service, practice management, sales, office administration or managed care experience.

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:
  • Competitive salaries
  • Paid vacation/time off
  • Continuing education opportunities
  • Generous retirement plan
  • Health insurance, including dental and vision
  • Sick leave
  • Service awards
  • Free parking
  • Short-term disability
  • Life insurance
  • Health care and dependent care spending accounts
  • Education assistance/continuing education
  • Employee referral program

Job Summary:
Position: 5901 - Representative-Provider Relations
Facility: BMHCC Corporate Office
Department: HS Provider Relations Corporate
Category: Administrative Non Clinical Support
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area
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