Provider Relations Representative I in Latham, NY at Beacon Health Options

Date Posted: 9/27/2019

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Provider Relations Representative I to join our team at our Cypress, CA office.  Under the general supervision of the Manager of Provider Relations, provides internal support and follow-through in completion of the Provider Relations function. This position conducts research, resolves problems follows up on a variety of provider issues that may arise.  The job also coordinates activities with other internal Beacon Health Options departments to provide optimal customer service to network providers and internal customers. The Providers Relations Representative I routinely interfaces with existing providers and providers’ office staff to develop a solid business relationship.

Shift: M- F 8:00 am – 4:30 pm (schedule may vary)

What does a typical day look like?

  1. Answer general provider questions about Beacon, its contracts, policies and procedures.
  2. Perform research and problem resolution on issues related to provider complaints, claims reported to have been processed incorrectly, coordinating credentialing paperwork, provider communications, or verification of information as requested.
  3. Remain current on regulatory and company policy that impacts the provider network and related issues.
  4. Answer practitioner/facility recruitment questions regarding joining Beacon’s network.
  5. Provide assistance in compilation and mailing of provider recruitment mailings, general information, and educational materials to network practitioners as required.
  6. Conduct outreach to providers for information, research or compliance with Beacon policies or programs including access and availability standards.
  7. Provide follow up with key practitioners and facilities for the return of completed credentialing and re-credentialing applications
  8. Provide general support to all network development activities.
  9. Respond to provider calls transferred by the Provider Services Line as well as emails, voicemails and faxes.
  10. Actively outreach and train providers to increase the rate of electronic transactions.
  11. Perform active outreach to ensure compliance with access and availability.
  12. Work with providers and network operations to ensure provider data submission and accuracy.
  13. Participate in the coordination and processing of all Network department mailings.
  14. Review claim reports for denial rates and work with providers to improve claim submissions.
  15. Build collaborative relationships with client health plan counterparts to ensure seamless customer service.
  16. Assists with network reporting activities.

 OTHER JOB FUNCTIONS

  1. Maintain professional growth and development through self-directed learning activities.
  2. Adhere to all Beacon policies and procedures and standards of operations.
  3. Complete all required and assigned trainings.
  4. Attend all mandatory company or department meetings.
  5. Display a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  6. Assist team members and offers suggestions to improve processes, culture, or work environment.
  7. Performs special projects and other duties as assigned and required.
  8. Ensure compliance with regulatory and NCQA requirements

What you Contribute?

Education: A high school or GED diploma is required.  An Associate’s Degree or equivalent related experience is preferred.

Licensure: N/A

Knowledge, Skills & Abilities:

  • Minimum 2 years’ experience in the HealthCare field.
  • Strong interpersonal skills and good written and verbal communication skills.
  • Computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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