Provider Relations Coordinator

Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Provider Relations Coordinator to join our growing team.

Job Summary:

The role of Provider Relations Coordinator holds a crucial position within the organization, employing specialized expertise in servicing provider questions and needs to ensure providers can operate effectively in the processes and systems we manage. Functioning as a vital liaison, this role actively contributes to recruitment endeavors and guarantees smooth communication between our team and providers. Attention to detail and adept multitasking skills stand as indispensable pillars, reinforcing our unwavering commitment to excellence in healthcare services.

Responsibilities:

• Initiate effective outreach to client identified providers using various communication channels, including phone and email.
• Systematically track and document provider responses, assessing geographical coverage by percentage.
• Demonstrate expertise in articulating the Acentra Health onboarding and screening process, providing comprehensive information, and addressing queries from potential providers regarding required documents.
• Collaborate seamlessly with the enrollment team to ensure accurate and timely completion of all enrollment and screening documents.
• Drive onboarding and retention efforts for practitioners and provider organizations.
• Thoroughly review and prepare contracts for both practitioners and provider organizations, encompassing in-network and out-of-network agreements, including single-case agreements.
• Efficiently handle data entry tasks related to network information and contribute administrative support to the enrollment team.
• Serve as a liaison for resolving practitioner/provider issues during the enrollment process.
• Generate client reports pertaining to the network and ensure their accuracy and relevance.
• Efficiently handle incoming calls from clients and network providers, addressing inquiries related to client benefits, procedures, paperwork, payments, and other questions to resolve provider inquiries.
• Review provider appeals and apply knowledge of correct coding principles to resolve pricing and payment concerns.
• Respond to provider grievances and appeals related to claims payments and document outcomes and justification for appeal decisions.
• Maintain provider policy documentation and communicate changes to providers.
• Host training and webinars for providers to help them keep current on policies and changes and enable the providers to become self-sufficient using our systems and tools.
• Provide guidance to the technical teams to assist with correct configuration of new Medicare billing codes and methods.
• Proactively manage the customer service escalation phone queue, responding to inquiries and following up on provider inquiries left in the voicemail box according to established workflows.
• Maintain precise client records in the database by diligently entering all calls, case updates, requests, and referrals accepted by clients, following Acentra Health policies.
• Other duties as assigned to help internal and external customers achieve client program goals.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Required Qualifications

• High school diploma or equivalent (bachelor's degree preferred)
• 2+ years of provider-facing experience in healthcare (e.g., health plan/provider relations, medical billing, claims…