Provider Relations Representative - Day -Quest Behavioral Health

Location: York Hospital, York, PA

Schedule: Full Time

Hours: M-F Day

Full time: 40 hours/week

General Summary

Develops and maintains relationships with healthcare providers. Explains the Plan's policies, procedures, and protocols to providers, and resolves providers' concerns and problems.

Essential Functions:

• Develops and maintains ongoing communication with providers, practice manager, and office staff representatives.

• Resolves provider's concerns and problems related to policies, procedures and protocols, the provider network and other related issues.

• Maintains confidentiality of provider information.

• Maintains up to date provider information required to meet Plan certification criteria.

• Forwards appropriate provider, and/or billing information to others to build out in our claims processing and credentialing systems.

• Assists in resolving claim issues.

• Runs reports as needed to ensure data quality and appropriate billing standards are met.

• Assists with preparing letter of agreements, single case agreements, and contracts as needed.

Travel Requirements:

• Estimated Amount: - Travel may be required.

Qualifications

Minimum Education:

• High School Diploma or GED Required

• Associates Degree Preferred

Work Experience:

• 2 years credentialing or provider relations experience required

• Claims experience preferred

• Epic experience would be a plus

• Great collaboration and organizational skills preferred

• Must have strong attention to detail

Courses and Training:

• Behavioral Health terminology. Required and

• AMA CPT-4 Coding Guidelines. Upon Hire Required and

• ICD-10 coding. Upon Hire Required

Knowledge, Skills, and Abilities:

• Ability to multi-task.

• Works independently by prioritizing workload.

• High level of organizational skills.

• Proficiency in data entry.

• Excellent communications/interpersonal and computer skills.

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At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email atcareers@wellspan.org. We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability, or any other legally protected characteristic.