Job description

** This position will only consider candidates whose highest attained degree is an RN (no advanced nursing degrees will be considered or allowed to function in this role)

EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

Bachelor’s Degree or 1-year experience equivalent to 1 year of college

2-4 years experience in provider relations

Experience and ability in developing provider relationships, knowledge of claims processing, managed care plan benefits, and utilization management

Valid Texas Driver’s License and ability to travel

Responsibilities

This position is responsible for provider outreach in support of developing and maintaining positive & professional relationships with current and potential KCA Network, Affiliate Network, KCP/IPA Network, and Physicians Group of Texas, LLC Expansion markets for commercial and Medicare Advantage products. Provider relations functions will include providing education, training, guidance, claims resolution, contract interpretation, and other duties as assigned.

Demonstrated knowledge of CPT and ICD-9 coding and prior experience with reimbursement methodologies

Proficient with Microsoft Word and Excel

Analytical and problem-solving skills; ability to communicate effectively in writing and verbally

Ability to work in a fast-paced environment; demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines

Demonstrated public speaking and presentation skills

Preferred Requirements

3+ years experience in applicable healthcare administrative operations.

2-4 years experience in provider relations preferred

Willingness to engage in local business travel

Proficient with Access and PowerPoint

Capable of managing a variety of complex issues while driving the momentum of key projects

Job Type: Full-time

Pay: $63,000.00 - $77,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Pearland, TX 77584: Reliably commute or planning to relocate before starting work (Required)

Willingness to travel:

• 25% (Required)

Work Location: In person

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