-
Provider Relations Representative
2 weeks ago
Gainwell Technologies LLC Newark, United StatesGreat companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your cont ...
-
Guest Relations Representative
4 weeks ago
Publicis Re:Sources Global New York, United StatesJob Description · Job DescriptionCompany Description · Publicis Re:Sources is the backbone of Publicis Groupe, the world's third-largest communications group. Formed in 1998 as a small team to service a few Publicis Groupe firms, Publicis Re:Sources has grown to 5,000+ people ser ...
-
Guest Relations Representative
1 week ago
CBRE New York, United StatesGuest Relations Representative · Job ID · 170885 · Posted · 10-Jun-2024 · Service line · Advisory Segment · Role type · Full-time · Areas of Interest · Customer Service, Property Management · Location(s) · New York - New York - United States of America, New York City ...
-
Patient Relations Representative
3 days ago
NYULMC New York, United StatesJob Description · NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, ...
-
Customer Relations Representative
2 weeks ago
Collectors Universe Jersey City, United StatesCollectors is the leading creator of innovative technology that provides value-added services for collectors worldwide. We grade, authenticate, vault and sell millions of record-setting collectibles, all while modernizing and digitalizing the process to further our mission of hel ...
-
Senior Guest Relations Representative
1 week ago
CBRE New York, United StatesSenior Guest Relations Representative · Job ID · 170856 · Posted · 10-Jun-2024 · Service line · Advisory Segment · Role type · Full-time · Areas of Interest · Customer Service, Property Management · Location(s) · New York - New York - United States of America, New Yor ...
-
Senior Labor Relations Representative
1 week ago
Metropolitan Transportation Authority New York, United StatesPosition at MTA Headquarters · JOB TITLE: Senior Labor Relations Representative · SALARY RANGE: $90,000 - $100,000 · HAY POINTS: 551 · DEPT/DIV: Labor Relations · SUPERVISOR: Assistant Director, Labor Relations · LOCATION: 420 Lexington Ave, 11th Floor · HOURS OF WORK: 8:30am - 5 ...
-
Associate Provider Relations Representative
1 week ago
Molina Healthcare New York, United States***Remote and must live in New York*** · Job Description · Job Summary · Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core ...
-
Associate Provider Relations Representative
3 weeks ago
Molina Healthcare New York, United States***Remote and must live in New York*** Job DescriptionJob SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, a ...
-
Client Relations Representative
1 week ago
Newport Associates Brooklyn, United StatesA Travel Client Relations Coordinator at the entry level is responsible for assisting with client communications and ensuring a smooth travel experience for customers. This role involves handling inquiries, providing information about travel packages, and addressing client concer ...
-
Prenuvo New York, United StatesAbout UsAt Prenuvo, we are on a mission to flip the paradigm from reactive "sick-care" to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no contrast). Our unique integrated stack of optimize ...
-
Customer Relations Representative
1 week ago
Linda Burchett - State Farm Agent New York, United States**ROLE DESCRIPTION**: · As a Customer Relations Representative with Linda Burchett Agency, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. Your attention to detail, customer service skills, and desire to hel ...
-
Customer Relations Representative
1 week ago
Austin Raab - State Farm Agent New York, United States**Position Overview**: · Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Customer Relations Representative - State Farm Agent Team Member. We seek an energetic professional interested in helping our business grow through ...
-
Customer Relations Representative
4 weeks ago
Rodney Shannon - State Farm Agent New York, United StatesJob Description · Job DescriptionPosition Overview · Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the career for you State Farm agents market only ...
-
Guest Relations Representative
1 week ago
CBRE New York, United States**Guest Relations Representative** · **Job ID** · **Posted** · - 10-Jun-2024**Service line** · - Advisory Segment**Role type** · - Full-time**Areas of Interest** · Customer Service, Property Management · **Location(s)** · New York - New York - United States of America, New York C ...
-
Associate Provider Relations Representative
3 weeks ago
Molina Healthcare New York, United StatesMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance Relations, Associate, Represe ...
-
Associate Provider Relations Representative
3 weeks ago
Molina Healthcare New York, United StatesJob Description · ***Remote and must live in New York*** · Job Description · Job Summary · Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overa ...
-
Associate Provider Relations Representative
3 weeks ago
Molina Healthcare New York, United States***Remote and must live in New York*** · Job Description · Job Summary · Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core ...
-
Associate Provider Relations Representative
3 weeks ago
Molina Healthcare Brooklyn, United StatesJob Description · ***Remote and must live in New York*** · Job Description · Job Summary · Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's over ...
-
Customer Relations Representative
6 days ago
Johan Hernandez - State Farm Agent White Plains, United States Full timePosition Overview · Successful State Farm Agent is seeking a qualified professional to join their winning team for the role of Customer Relations Representative - State Farm Agent Team Member. We seek an energetic professional interested in helping our business grow through value ...
Associate Provider Relations Representative - New York, United States - Molina Healthcare
Description
Job Description
Job Summary
Molina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
Job Duties
This role serves as partner to the Provider Contracting and Provider Relations Team in regards to receiving, researching and responding to provider inquiries. It is internal and external facing position requiring job knowledge to resolve basic provider inquiries and communication skills to successfully engage with providers and maintain provider satisfaction primarily for non-complex Providers including but not limited to Fee-For-Service and Pay for Performance Providers.
• Receives, researches, and resolves provider inquiries such as claims, eligibility, and other inquiries. Act as a liaison between the providers, medical groups and health plan.
• Duties may include: (a) Price specific services based on the Plan's fee schedule; (b) Communicate and educate providers on important changes to regulations, procedures and access to information; (c) Assist Providers in dismissing or moving members incorrectly assigned to them; and/or (d) Educate providers so the appropriate dismissal letters are sent to Molina members.
• Supports other members of the Provider Services Team when they are in the field.
• Responsible for documenting requests as required in departmental procedures.
• Assists with training of new Provider Services staff members, including orientations, website navigation and education.
• Attends off-site meetings when necessary with medical groups and other providers as needed.
• Performs Mailbox Support .
• Complies with required workplace safety standards.
Job Qualifications
REQUIRED EDUCATION :
High School Diploma or equivalent GED
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :
1 year customer service, provider service, or claims experience in a managed care or medical office setting.
PREFERRED EDUCATION :
Associate's Degree
Vocational program in Managed Care or some other health care aspect providing a certificate at completion.
PREFERRED EXPERIENCE :
• Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation and various forms of risk, ASO, etc.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $ $31.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 05/13/2024
