Palm Beach Accountable Care Organization · 8 hours ago
Provider Consultant
Atlanta, GA
Full-time
Remote
Entry, Mid Level
$60K/yr - $65K/yr
2+ years exp
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Responsibilities
Serve as the primary liaison between The Healthcare Network and the participating provider community who service our members in multiple product lines throughout Southeast Atlanta.
Build and maintain strong relationships with providers by offering excellent customer service to assigned primary care, and specialty care physicians with routine and targeted education visits for the purpose of continued education regarding policies/initiatives. Service also includes supply deliveries and prompt follow up regarding claims, benefits and procedural guidelines for authorization of services.
Conduct on-site visits, telephone conversations and written communications with individuals including Hospital executives, Patient Account Managers, Physicians, Office and Billing Managers.
Perform on-site provider orientations and group county orientations for new primary care, and specialty care physicians regarding policies, procedures, billing and company-wide initiatives.
Consults with physician offices to develop training curriculum specific to client process and work flow for optimal use and operation of EHR systems.
Analyzes workflow by observing customer operations for three days and configures system to the customer’s workflow.
Maps customer’s data from current system to new EHR system.
Represent the Provider Relations Department and Practice Transformation Specialist in work groups and committees that address both internal and external customer concerns regarding the operations of The Healthcare Network as it pertains to the provider community.
Other duties as assigned.
Applicant must be highly proficient and creative at identifying and solving problems. Incumbent must be able to work independently as a telecommuter and attend off-site meetings; including overnight stays.
Communicate effectively as a liaison between the provider community and PBACO in order to provide education on policies and procedures as well as, to assist in the resolution of issues or concerns a provider may have.
Provider Orientations: Perform on-site provider orientations for primary care, specialty care physicians regarding policies, procedures, billing and company-wide initiatives within 30 days of becoming credentialed and approved. Oversee group county provider orientations by determining location, arranging for mailing of invitations and make available at the presentation PBACO provider forms, QI Manuals, directories and the PBACO Provider Office Policy and Procedure Manual, as needed.
Goal/Target Visits: Service primary care, and specialty care physicians within a specific geographic territory by conducting annual Goal / Target visits for the purpose of continued education regarding policies/initiatives. Each Provider Relations Representative will schedule minimally one goal visit per year with participating practices in the following specialties: Primary Care / Specialists.
Qualification
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Required
2 years’ experience required in Provider Relations and/or Managed Care Product Administration
Highly proficient and creative at identifying and solving problems
Ability to work independently as a telecommuter and attend off-site meetings, including overnight stays
Communicate effectively as a liaison between the provider community and PBACO in order to provide education on policies and procedures as well as, to assist in the resolution of issues or concerns a provider may have
Perform on-site provider orientations for primary care, specialty care physicians regarding policies, procedures, billing and company-wide initiatives within 30 days of becoming credentialed and approved
Service primary care, and specialty care physicians within a specific geographic territory by conducting annual Goal / Target visits for the purpose of continued education regarding policies/initiatives
Willingness to travel: 75%+ (Required)
Preferred
Bachelor’s degree in Business Administration, Marketing, Health Care Administration or Other Related Degree
2 years’ Provider Relations experience or medical office or hospital experience
2 years’ exposure to medical claims processing procedures
Knowledge and understanding of the dynamics of Managed Care environment, including capitation and reimbursement structure
Bilingual: English/Spanish
Benefits
401(k)
401(k) matching
Dental insurance
Flexible schedule
Health insurance
Paid time off
Tuition reimbursement
Vision insurance
Company
Palm Beach Accountable Care Organization
Palm Beach Accountable Care Organization physicians have identified prevention as a key factor in improving overall patient health.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Amanda Larschan, MHA, PMP
Chief Data Officer
Company data provided by crunchbase
