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Cynet Systems · 2 months ago

Provider Relations Representative - Remote / Telecommute

United States

Full-time

Remote

Mid Level

$24.88/hr - $32.88/hr

4+ years exp

Cynet Systems is a company focused on provider relations, and they are seeking a Provider Relations Representative to support providers through education, relationship management, and issue resolution. This role involves partnering with the Provider Training and Education Department and providing analytical support to ensure smooth operational and contractual alignment.

EmploymentRecruitingStaffing Agency

Growth Opportunities

Responsibilities

Partner with the Provider Training and Education Department to educate providers on programs, processes, and electronic tools

Provide targeted training to help providers successfully navigate the provider portal and follow company procedures

Support one or more health systems representing multiple practices to ensure Tier One Service delivery

Provide research, analytical, and resolution support for special projects and complex cases

Respond verbally or in writing to inquiries from management, internal teams, and external customers

Assist providers in resolving escalated service-related issues and inquiries through face-to-face visits, correspondence, email, and phone

Build and maintain strong relationships with providers through regular communication and timely problem resolution

Proactively identify provider needs and address them through problem solving and collaboration with internal and external resources

Leverage provider relationships to drive and influence provider behavior towards favorable outcomes

Qualification

Provider billingCodingManaged care regulationsContractual document interpretationMicrosoft ExcelAnalytical problem-solvingRelationship managementCommunication skills

Required

High school diploma or equivalent

Minimum of 4 years of experience in the healthcare industry, including experience with providers, training, claims, customer service, and presentations

Experience working with providers in a managed care or insurance environment

Experience in training and educating provider networks

Experience handling provider issues and resolving escalations

Proficient knowledge of provider billing and coding mechanisms

Strong understanding of managed care industry regulations and third-party payment methodologies

Ability to interpret and communicate contractual documents effectively

Proficiency in Microsoft Excel, Access, PowerPoint, and Word

Excellent communication and relationship management skills

Strong analytical and problem-solving abilities