Job description

Job Title :Provider Relations Specialist II

Location :Albany, NY, Getzville, NY, Latham, NY, Rego Park, NY, Syracuse, NY,
Utica, NY,

Duration :Permanent Position

($3K Sign on Bonus)

Job description

You could be the one who changes everything for our 26 million members. is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

Serve as a liaison between providers, the health plan and Corporate to investigate and resolve provider claims

Conduct on-site provider orientations

Monitor financial performance of contracts

Investigate and document provider changes and correspondence

Coordinate with credentialing to ensure all appropriate documentation is received

Serve as a lead for key special projects

Investigate and respond to complex provider related issues and initiate change of provider related database information

Ability to travel - 75%

Education/Experience: High school diploma or equivalent. Bachelor’s degree in healthcare related field preferred. 5+ years of sales, provider relations, or contracting experience. Claims processing and/or managed care experience preferred. Driver’s License may be required by some plans. Specific language skills may be required by some plans.

License/Certification: Valid driver's license.

For Fidelis Care only: Must have valid driver license, personal vehicle and ability to travel.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

It is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Job Type: Full-time

Salary: $65,000.00 - $75,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Supplemental pay types:

• Signing bonus

Ability to commute/relocate:

• Rego Park, NY 11374: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• How would you handle a difficult situation with a provider?
• Where is the candidate currently located?
• Please explain all employment gaps on the candidates resume.
• If the candidate is currently employed, why are they seeking a new opportunity?
• How would your colleagues describe you?
• Why are you interested in this role?

Experience:

• Call center: 1 year (Preferred)
• Customer service: 1 year (Preferred)

Work Location: One location

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