Provider Relations Representative

We are looking for an experienced and motivated Provider Relations Representative to join our team at BlueCross BlueShield of South Carolina. This role will be responsible for cultivating and maintaining relationships with providers, and ensuring that they are properly credentialed and contracted. The ideal candidate will have a solid understanding of provider relations and contracts, as well as strong communication and customer service skills. If you have a passion for delivering quality service and helping providers achieve success, we would love to hear from you.Required Qualifications: • Bachelor’s degree in Healthcare Administration or a related field• At least 3 years of provider relations experience • Knowledge of provider network management operations• Excellent communication and customer service skills • Ability to work independently and manage multiple tasks • Strong organizational skills and attention to detail

Responsibilities:

1. Establish and maintain relationships with providers and ensure they are properly credentialed and contracted.
2. Develop provider networks and ensure compliance with contractual obligations.
3. Monitor provider performance and satisfaction levels.
4. Participate in provider meetings and provide feedback on performance and contract issues.
5. Resolve provider disputes and ensure providers receive appropriate compensation according to contracts.
6. Develop and implement policies and procedures to ensure smooth operations of provider networks.
7. Attend industry events and seminars to stay up to date on best practices and industry trends.
8. Handle provider inquiries and complaints in a timely and professional manner.
9. Update provider records and maintain accurate documentation.
10. Analyze data to identify and address potential problems.

According to JobzMall, the average salary range for a Provider Relations Representative in Lexington, SC, USA is $36,000 to $48,000 per year. This range varies depending on the company, the individual's experience, and the industry.

BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. BlueCross serves 21.5 million people through private business and government contracts.