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Provider Services Representative I

Provider Services Representative I

Methodist Health SystemDallas, TX, US
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Associate Provider Services Representative

Hours of Work : 8am-5pm

Days Of Week : M-F

Work Shift : Day

Job Description : The purpose of the Associate Provider Services Representative is multifaceted; it requires excellent interpersonal and communication skills, knowledge of managed care / health plans, and an understanding of the health care industry in order to effectively educate, communicate, share information, and facilitate relationships with Dallas Methodist Physicians Network (DMPN) physicians and their office personnel; Methodist Patient Centered ACO (MPCACO) physicians and their office personnel; and representatives of Methodist system hospitals and other facilities. Essentially, the job purpose is to foster collaborative relationships between all parties and in doing so advancing the mission, vision and values of Methodist Health System (MHS).

Job Requirements :

  • Bachelor's degree preferred
  • Must demonstrate a high degree of independence and be a self-starter.
  • Must demonstrate the ability to respond to the expressed needs and concerns of physicians and office staffs, as well as initiate actions and proactively anticipate next steps.
  • Must demonstrate well-developed communication skills, both oral and written, to enable strong interpersonal interactions with physicians and office staffs.
  • Must demonstrate understanding of medical claims billing and coding practices.
  • Ability to analyze problems / issues / questions and independently research to find answers.
  • Ability to organize and set priorities to complete projects within a specified timeline.
  • Ability to multi-task and adapt to changing priorities.
  • Ability to maintain strict confidentiality.
  • Proficient in Microsoft products : Outlook, Word, Excel, and PowerPoint.
  • Work Experience : 1-5 years' experience in managed care or related field preferred. Marketing experience is a plus.

Job Responsibilities :

  • Assists newly credentialed DMPN and MPCACO physicians within the first few months : Provides education to physicians and office personnel on the health plan contracts, fee schedules, claims processes, and regulatory requirements.
  • Serves as liaison between MHS physicians / office staffs and Managed Care Organizations : Facilitating collaborative relationships with health plan representatives Obtains feedback from physician offices on health plans and health system issues; Identifies needs and opportunities for improvement; Provides quick response and follow-up with physicians concerns, problems and questions; and Monitors health plan websites to gather information to be used for communications to physicians and office staff.
  • Establishes, cultivates and maintains positive relationships with DMPN and MPCACO providers and their office staffs through : Communicating with physician practices routinely Documenting contacts with physicians and staff through weekly summaries and monthly written reports Writing a monthly physician newsletter Conducting meetings with physicians and their office STAFF to share information, Working with physicians on the development of medical neighborhood and assisting in communication flow, Educating physicians on HCCs and quality metrics, and Attending physician events and meetings to help maintain visibility with physicians.
  • Coordinates joint operating committee meetings with health plan representatives.
  • Assists in the implementation of new health plan contracts.
  • Develops and maintains health plan contacts and contract grids / databases / spreadsheets.
  • Maintains DMPN's and MPCACO Pulse sites with current information.
  • Performs a variety of special projects and other related duties to support goals including business development, growth, and quality and physician satisfaction.
  • Projects a positive image of MHS to internal colleagues, external customers and the community.
  • Methodist Health System is a faith-based organization with a mission to improve and save lives through compassionate, quality healthcare. For nearly a century, Dallas-based Methodist Health System has been a trusted choice for health and wellness. Named one of the fastest-growing health systems in America, Methodist has a network of 12 hospitals with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Methodist has more than two dozen clinics located throughout the region, renowned teaching programs, innovative research, and a strong commitment to the community. Our reputation as an award-winning employer shows in the distinctions we've earned :

  • Magnet designations for Methodist Dallas, Methodist Charlton, Methodist Mansfield, and Methodist Richardson Medical Centers
  • 150 Top Places to Work in Healthcare by Becker's Hospital Review, 2023
  • Top 10 Military Friendly Employer, Gold Designation, 2023
  • Top 10 Military Spouse Friendly Employer, 2023
  • TIME magazine Best Companies for Future Leaders, 2025
  • Great Place to Work Certified, 2025
  • Glassdoor Best Places to Work, 2025
  • PressGaney HX Pinnacle of Excellence Award, 2024
  • PressGaney HX Guardian of Excellence Award, 2024
  • PressGaney HX Health System of the Year, 2024
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