Provider Relations Coordinator-MCO Claims
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Job Location:
Hanover, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
What awaits you:
- Work-life balance - This is a hybrid role. Must work one day per month in our Hanover MD location.
- Great hours- Monday-Friday 8am-4:30pm
- Medical Dental and Vision Insurance.
- 403B Savings Plan w/employer contribution.
- Paid Time off & Paid holidays.
- Employee and Dependent Tuition assistance benefits.
- Health and wellness programs and MORE!
Please note: US citizenship is required for this position as it falls under the terms of a government contract (to ensure compliance with DODPSP).
Who you are:
As a Provider Relations Coordinator for Johns Hopkins Health Plans you are the go-to for our providers when it comes to everything from eligibility appeals process and most importantly complex claims resolution.
What youll do:
- Provider Relations administrative and operational duties:
- Complex claim research and resolution
- Supporting Customer Service with calls as needed
- Network Maintenance regarding claim payment
- Eligibility
- Benefit interpretations
- Referral and appeals process
- Provider contract discrepancies
- Provider portal questions
- Provider Credentialing Process related to applications and documentation as well as inbound and outbound communications
- Provider Education and Communication
- Department projects and meetings
What youll bring:
- 3 years current experience in managed care or medical billing experience
- Claims experience
- Experience within a provider portal also highly preferred
- Our ideal candidate will have proficient PC skills to include experience in healthcare databases- Epic Facets HealthSuite Excel.
- Excellent written and oral communication skills.
- Excellent interpersonal skills are required in relating to providers or business associates in all type of situations.
- Strong analytical ability to gather and interpret data from different sources and to resolve moderately complex problems.
- High School Diploma or equivalent
- Associates degree preferred.
Who we are:
Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500000 active members with lines of business in Medicaid Medicare commercial military health health solutions and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare at Johns Hopkins Health Plans we are setting the pace for change within the healthcare industry. We develop innovative analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered and have a passion to be at the forefront of change JHHP is the place to call home.
Salary Range: Minimum 22.00/hour - Maximum 36.32/ will be commensurate with equity and experience for roles of similar scope and responsibility.
In cases where the range is displayed as a $0 amount salary discussions will occur during candidate screening calls before any subsequent compensation discussion is held between the candidate and any hiring authority.
JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!
Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment where we embrace and celebrate our differences where all employees feel valued contribute to our mission of serving the community and engage in equitable healthcare delivery and workforce practices.
Johns HopkinsHealth Systemand its affiliatesare an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Required Experience:
IC
Key Skills
- Revenue Cycle Management
- Marketing
- Public Relations
- Algebra
- MailChimp
- Media Relations
- Social Listening
- Relationship Management
- Customer relationship management
- Medicare
- Public Speaking
- Writing Skills
About Company
Johns Hopkins Medicine is a leading health system and academic institution in the U.S. Find information about doctors, locations, appointments, billing, research, education and more.
