Palm Beach Accountable Care Organization · 3 hours ago
Provider Consultant
Miami, FL
Full-time
Onsite
Entry, Mid Level
2+ years expPalm Beach Accountable Care Organization is seeking a Provider Consultant to serve as the primary liaison between the Healthcare Network and the provider community. The role involves building relationships with providers, conducting orientations, and addressing operational concerns to enhance service delivery.
Health CareInformation Technology
Responsibilities
Serve as the primary liaison between The Healthcare Network and the participating provider community who service our members in multiple product lines throughout the network
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, telephonic 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
Represent the Provider Consultant Department in workgroups 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
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 Consultant will schedule minimally one goal visit per year with participating practices in the following specialties: Primary Care / Specialists
Qualification
Required
2 years' experience required in Provider Relations and/or Managed Care Product Administration
Valid unrestricted driver's license
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
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
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