Coordinator - Healthcare Provider Relations - PACE Program - Reseda / West Los Angeles
Location :
Reseda, CA
Job Type :
Direct
Job Industry :
Healthcare - Health Services
Job Description :
Coordinator - Healthcare Provider Relations
Provider Network Assistant - PACE Program
Reseda / West LA Float, CA
Requirements to apply:
- Education/Degrees: High School Diploma required. Associates or Bachelor's degree in any field or equivalent experience preferred.
- Experience: Strong computer skills are required. One to three years of Healthcare Experience working in a provider relations or customer service environment.
Schedule: Monday-Friday 8:00am-5:00pm
Location: Primary location Reseda with potential to float to West LA.
Pay Rate: $20.00-$23.00 per hour
Under the direction and supervision of the Director, and the Provider Network Specialist, the Provider Network Assistant is responsible for assisting with, and maintaining, provider and vendor contracts with the PACE program, addressing provider and vendor customer service issues and maintaining the provider/vendor database.
Responsibilities:
- Assist with the initiation, management, and renewal of provider and vendor contracts assigned by the Director.
- Ensures contracts comply with federal, state, and local authorities and regulators.
- Stays abreast of federal, state, local and private reimbursement schedules applicable to assigned categories of providers.
- Ensures feedback mechanism and coordination of information for provider credentialing results with the Provider Network Specialist.
- Maintains and updates the provider/vendor database accurately and in a timely fashion.
- Reviews all questionable claims, discusses with Provider Network Specialist and resolves them quickly by coordinating with necessary personnel and provider.
- Ensures that providers maintain a solid working knowledge of Provider Dispute Resolution procedures.
- Participates in meetings assists marketing on community outreach and enrollment and on community health-related projects as needed.
- Assists with regulatory audit preparation and ensures readiness.
- Assist with completion of required internal audit completion.
- Assists in the development of written material for the provider newsletter and other publications deemed appropriate.
- Complies with safety policies and procedures, identifying and immediately reporting any potential or actual unsafe acts or conditions to the Executive Director. Takes necessary measures to ensure a safe environment for oneself, co-workers, contractors, participants, visitors and others.
- Consistently meets or exceeds targets for productivity.
- Continually seeks better ways for delivering services and communicating with participants.
- Consistently meets or exceeds customer service targets.
- Demonstrates respect for and promotes participant rights, including dignity, self-determination, access to care, confidentiality and independence.
- Understands the importance of community involvement and participates as appropriate in activities that link to its communities.
- Effectively collaborates with staff peers and contractors to meet goals and further success.
Why us?
We value our employees! We offer long term employment opportunities with job stability, including supporting and encouraging career growth advancement. We offer Health, Dental and Vision insurance, Paid Time Off, 9 Paid Holidays, 403(b) with Matching Retirement Plan, Life insurance (paid by the company) and a team spirit workplace culture!
Required Qualifications :
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