Job Description:
Blue Cross of Idaho is looking for Provider Relations Representative to work independently to serve as the liaison and maintain open communication between Blue Cross of Idaho (BCI) and the providers of healthcare services regarding company policies and payment procedures. Train and educate providers on BCI's fee-for-service and value-based contracts as well as the requirements and procedures associated with the contracts. Heavy travel schedule required.
We are looking for a Provider Relations Rep with:
Provider Relations Rep I:
- Experience: 4 years' provider service or health industry experience
- Education: High School or equivalent
Provider Relations Rep II:
- Experience: 8 years' provider service or health industry experience
- Education: High School or equivalent
What your day may look like:
- Coordinates the resolution of provider contracts, agreements, fee schedules, and payment problems.
- Collaborates with key stakeholders to identify and resolve issues.
- Coordinate's resolution of contract or agreement issues. Communicates critical issues and provides recommendations to leaders.
- Educates providers on policies, procedures, practices, and data integrity. Ensures providers are informed on changes/updates to policies, procedures, and practices.
- Ensures department and provider compliance with regulatory agencies.
- Coordinates cross departmental activities and projects to support and adhere to the provider contract requirements.
- Performs research to respond to inquiries and interprets policy and procedures to determine effective response.
- Provides welcome information to newly contracted providers.
- Promotes provider participation in on-line tools and programs available.
- Performs other duties and responsibilities as assigned.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
