Provider Relations Representative
Builds and maintains strong relationships with LifeWork Strategies (LWS) Employee Assistance Program (EAP) network Providers through excellent customer service and follow through. Develops and maintains contractual relationships with providers and ensures the development of the network to meet needs of EAP. Splits time between recruiting qualified new providers and handling concerns from existing network contracted providers. Some clerical and administrative duties relating to maintaining and recruiting providers. Answering and responding to inquiries.
Principle Duties and Responsibilities:
Serve as a point of contact for LWS EAP network providers and potential network providers.
Answer questions on role/responsibilities of EAP network providers.
Recruit providers for new EAP accounts, ad hoc requests, and areas with need for additional providers.
Negotiate rates with providers.
Credential and re-credential EAP providers.
Enter accurate and timely documentation of new provider credentials into database and electronic filing system.
Auditing provider files and re-credential as appropriate.
Process, track and file credentialing applications within established standards.
Respond to internal and external inquiries regarding credentialing status.
Follow up on materials sent within established standards.
Identify ways to improve existing process flows and forms.
Other special projects as they arise.
Must possess a strong knowledge of healthcare as obtained through the completion of a Bachelor's Degree in healthcare administration, business, or related field or an Associate's Degree and equivalent experience.
Prefer credentialing, provider data or provider enrollment experience with a health plan or provider.
Demonstrate high degree of customer focus.
Maintain professionalism and confidence in stressful situations.
Consistent and reliable attendance.
Display excellent organizational skills, prioritize, and multi-task under deadlines.
Commitment to teamwork.
Must be flexible and adaptable to a growing, fast paced workplace environment.
Excellent verbal and written communications skills.
Strong professional and interpersonal skills.
Must have the ability to take initiative and follow through on requests in a prompt and thorough manner.
Demonstrate analytical and problem solving skills.
PC and MS Office proficiency required.
Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.
Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.
Equal Employment Opportunity
Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.