Provider Relations Coordinator
Posted on: January 16, 2022
Overview:Responsible for supporting the administrative functions
of the provider networks and serving as a resource for the network,
department and clinician network liaisons. Support the Provider
Relations Manaagers who are responsible for the operations of the
provider network(s) in assigned region, and is the direct interface
between Optum and the affiliate physician network. This position
provides continuous education, support, training and
troubleshooting to physicians and their staff. Serve as an
interface between the central departments and the Independent
Physician Association (IPA) network.Essential Functions:
- Consistently exhibits behavior and communication skills that
demonstrate Optums commitment to superior customer service,
including quality, care and concern with each and every internal
and external customer.
- Resolves provider issues by interfacing with Optum central
departments (Contracting, Eligibility, Claims and Finance).
- Reports systemic operational issues to the management
- Coordinates provider outreach for the CCR.
- Follows up with Payor Contracting department on status of
clinicians being added, terminated as well as open / closed panel
status based on health plan website and submitted information.
- Verifies annually the single / dual affiliation status of
physicians and follows up when they are not maintaining this
- Serves as a point of contact to central departments for issues
related to the network, communicates relevant information from the
central departments to the network and provides communications and
documents upon request.
- Makes outreach and follow up phone calls to physician offices
related to specific initiatives or meetings (i.e. leadership
retreat, RADV audit and AEP meetings).
- Researches pay for performance discrepancies.
- Completes Notice of Changes and Preferred Provider Lists
ensuring information on these forms are inputted in IDX, Optum
Connect, Visual Cactus and health plan websites.
- Attends and helps prepare adhoc meetings (i.e. office manger
HCC training and lunch and learn).
- Takes minutes for specialty JOC meetings.
- Assists management in developing a quarterly IPA Bulletin
containing articles and announcements for the IPA network.
- Prepares benefit flyers for primary care physicians with health
plan ID numbers.
- Serves as administrative support for Clinician Network Liaisons
on days they are not in the office.
- Collects bios and pictures for website.
- Responds timely to CSRs.
- Delivers incentive and other checks.
- Responds to and resolves questions or concerns from clinicians
or staff in a timely and service-oriented manner.
- Uses, protects, and discloses Optum patients protected health
information (PHI) only in accordance with Health Insurance
Portability and Accountability Act (HIPAA) standards.
- Performs additional duties as assigned.Education: Minimum: High
School diploma, G.E.D. or equivalent Preferred: Associate's or
Bachelor's degree (open to new grads!)Experience: Minimum:
- Over 1 year and up to and including 3 years of experience.
- Customer service experience.
- Prior office support experience. Preferred: Over 3 years of
experience within healthcare industry.
- Experience using different portals and applications.
- Experience working with EMR systems.
- Knowledge of PIP, IDX, and Touchworks is a plus!
- Prior experience in a health plan, medical group or IPA setting
working with physician networks.Knowledge, Skills, and Abilities:
- Computer literate.
- Microsoft Office applications skills (Word, Excel).
- Good understanding of HMO systems provider reimbursement
- Knowledge of CPT-4 and ICD-9 coding systems.
- Excellent verbal and written communication skills.
- Ability to interface with all levels of management
- Strong customer service and interpersonal skills.
- Ability to write letters and articles.
- Excellent organization skills
- Able to type 25 wpm.
- 10-key skills
- Customer service oriented
- Filing skills
- Strong analytical and problem solving skills
- Ability to work on multiple assignments and manage time
- Knowledge of medical terminology
- Detail oriented
- Demonstrated ability to take initiative, ask questions, and
- Capable of working independently as requiredRequirement:Full
COVID-19 vaccination is an essential requirement of this role.
UnitedHealth Group will adhere to all federal, state and local
regulations as well as all client requirements and will obtain
necessary proof of vaccination prior to employment to ensure
compliance.UnitedHealth Group requires all new hires and employees
to report their COVID-19 vaccination status.Careers with Optum.
Here's the idea. We built an entire organization around one giant
objective; make health care work better for everyone. Optum, part
of the UnitedHealth Group family of businesses, brings together
some of the greatest minds and most advanced ideas on where health
care has to go in order to reach its fullest potential. For you,
that means working on high performance teams against sophisticated
challenges that matter. Here youll find incredible ideas in one
incredible company and a singular opportunity to do your life's
best work. (SM)Diversity creates a healthier atmosphere: Optum and
its affiliated medical practices are Equal Employment
Opportunity/Affirmative Action employers and all qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, age, national origin, protected
veteran status, disability status, sexual orientation, gender
identity or expression, marital status, genetic information, or any
other characteristic protected by law. Optum and its affiliated
medical practices is a drug-free workplace. Candidates are required
to pass a drug test before beginning employment.
Keywords: Optum, Arcadia , Provider Relations Coordinator, Other , Arcadia, California
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