Provider Relations Representative I

Summary Description:

We are seeking a detail-oriented Provider Relations Representative to support the accuracy, integrity, and maintenance of provider information across our systems. In this role, you will collaborate closely with internal departments, respond to provider inquiries, resolve data issues, and ensure compliance with organizational standards. The Provider Relations Representative plays a key part in supporting provider access, data management, and operational efficiency.

Key Responsibilities:

• Add, update, and maintain provider data in accordance with internal policies, procedures, and quality standards.
• Investigate and resolve provider data issues as they arise, document findings and corrective actions.
• Update and maintain provider reports and directories.
• Provide medical providers and administrators with access to online eligibility verification.
• Process applications and requests for system access; manage the assignment of usernames and passwords.
• Conduct testing of system and related reports when updates are implemented and Facets Application Software as requested.
• Participate in and support the work needed for annual provider surveys and network filings.
• Support cross-functional teams and complete special projects as assigned.

• Associate degree in Business Administration or a related discipline, or equivalent experience.
• Minimum of 2 years of related experience in the healthcare industry; HMO experience preferred.
• Experience with Facets Application Software is a plus.
• Intermediate computer skills, including email, databases, word processing, spreadsheets, and reporting tools.
• Ability to speak, read, write, and understand the primary language(s) used in the workplace.
• Strong attention to detail, problem-solving ability, and organizational skills.Bottom of Form

Salary:

$20.00 to $23.00 Hourly

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.