Provider Relations Representative
About the role
The Provider Relations Representative is an experienced customer service professional with excellent interpersonal, verbal, and written communication skills. The Provider Relations Representative serves as the first point of contact for Versant’s provider network. This individual will have the skill set to analyze and problem solve any claims-related issues and make system updates to provider demographic information as needed. This individual must have excellent organizational skills and be able to multi-task. The Provider Relations Representative will assist the Provider Relations Manager with network recruitment activities and provider network updates. He or she will prepare documents for Credentialing, review and monitor provider complaints, grievances, and escalated issues as necessary to the appropriate staff.
Responsibilities
- Serve as initial contact and respond to all provider related inquiries with exceptional service and timely responses in a professional and courteous manner
- Resolve and respond to provider claims issues and complaints: identify and correct fee schedule issues; submit requests for adjustments to claims; provide education to providers and their office staff regarding processes and changes; accurately update systems with changes in provider information
- Process recruitment materials and applications received from providers
- Assist in recruitment projects, network comparisons and data entry
- Initiate improvements to processes and procedures for Provider Relations that support company and departmental standards and strategic directives
- Other duties as assigned
Requirements
- High school diploma or equivalent required
- Three (3) or more years of customer service and administrative experience
Qualifications
- Associate’s degree preferred
- Preferred experience in a managed health care environment, provider relations and/or customer service
- Understanding of vision care insurance is a plus
- Must comply with HIPAA and follow company data security guidelines
Skills
- Excellent interpersonal, verbal, and written communication skills
- Ability to analyze and problem solve claims-related issues
- Strong organizational skills
- Ability to multi-task
Benefits
- Medical, dental, and paid vision coverage
- Paid time off and company holidays
- Retirement savings with employer contribution
- Employee wellness resources
- Professional development opportunities
- Flexible work arrangements
- Employee assistance programs
- Additional programs supporting work and personal well‑being
Pay
The expected hourly pay range for this position is $20 – $21 per hour, based on factors such as experience, skills, and role requirements.