Provider Relations Representative

Job Description

Job Description

JOIN UHA’S TEAM

We focus on your health and pay 100% for your family's medical insurance and provide 20 days of paid personal time off during your first year

Provider Relations Representative

Department : Health Care Services

FLSA Status : Full Time, Non-Exempt

Salary Level : 3

Position Summary :

Perform duties to maintain the integrity of the provider information in UHA’s claims processing system. Provide customer service to our Provider Network via phones, email, etc.

Follows department procedures to ensure consistency in operations. Provide general administrative support to the department.

Essential Duties & Responsibilities :

• Maintain integrity of contract templates, contract files, correspondence templates, etc.
• Receive, address, file and / or route applicable provider mail, faxes and phone calls
• Provide phone support to Customer Service for provider-related questions
• Receive and respond to emails received via Contracting Services inbox
• Process and track provider demographic forms daily
• Process and track pended claims in UHA claims processing system daily
• Process and track Online Registration forms daily
• Process and track EFT requests daily
• Coordinate, intake, and track all new Provider Watch requests
• Coordinate daily intake to track all new UHA network providers
• Audit automated pended claims and demographic form tasks
• Assist in process flow creation and changes for further process automation and improvement
• Complete daily progress report
• Other duties as assigned
• This Position prohibits any activity that requires interpretation of clinical information to customers, including the choosing of a set of criteria to use for handling a request for healthcare services or treatment

Required Education and Experience :

The individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• 2 years work experience within healthcare, health insurance, or professions which require data entry, auditing, claims processing, or workflow management required
• High School Diploma or equivalent

Preferred and Advanced Qualifications :

Bachelor Degree from accredited university / college

• This position is eligible to work from home with management approval
• The individual in this position must reside on Hawaii

Competitive compensation & excellent benefits offered

Visit our website at https : / / uhahealth.com / page / career -opportunities to apply and for details about vacant positions.

An Equal Opportunity Employer