Provider Relations Specialist
Location
Work from home | India
Job description
- We are seeking a passionate and talented Provider Relations Specialist to join our team
- You will secure relationships with private practice physicians and independent physician-owned facilities, for commonly utilized and elective medical treatments and services
- You will be the liaison between our team of network physicians, hospitals, surgical centers, and Nomi s operations team to ensure appropriate management of Open Network contracts and payment agreements
How you will make an impact
- Conducting introductory sessions for new providers and maintaining consistent communication with existing participants within the Open Network
- Recognizing and updating product-related information, such as name/brand awareness, regularly disseminating newsletters featuring new clients, product developments, Nomi engagement staff, and more
- Ensuring adherence to current Policies and Procedures (PPs) pertaining to member identification, coordination of Open Network referrals, as well as billing and payments
- Engaging in continuous Open Network outreach, reviewing, and refining existing contractual network services, locations, and pricing to optimize access, enhance patient satisfaction, and maximize revenue potential
- Managing and escalating contract-related issues to Provider Engagement territory managers
- Demonstrating a proficient grasp of CPT Coding with professional and hospital claims to assist in resolving claims and payment matters when necessary
- Guaranteeing accurate and systematic handling of contracts, provider rosters, and fee tables for seamless integration into the Contract Database Management platform
What we are looking for
- A minimum of two (2) years of experience in Provider Relations
- Practical familiarity and experience with Open Network contract templates, along with CPT and DRG coding
- Past involvement in Project Management
Job tags
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