Provider Relations Representative

A

Astrana Health, Inc.

Posted 3 months ago

Full Time

Daly City, California

In Person

Smart Summary

Responsibilities

The role involves providing field and office support to the IPA's provider network to ensure compliance with Health Plan standards. Key duties include responding to provider inquiries regarding billing and claims while maintaining accurate provider records.

Qualifications

You have an Associate's degree or related field and 1-2 years of experience in provider network management or a similar healthcare role. You are proficient in Microsoft Office Suite and possess excellent communication and interpersonal skills, with the ability to travel regularly within San Francisco and San Mateo County.

Must Have Skills for ATS

Microsoft Office

Excel

Word

PowerPoint

Outlook

Job Description

Provider Relations Representative

Department: Market Ops - Bay Area

Employment Type: Full Time

Location: 355 Gellert Blvd, S200, Daly City, CA 94015

Reporting To: Kevin Phan

Compensation: $28.00 - $33.00 / hour



Description

We are currently seeking a driven Provider Relations Representative who will be responsible of both field and office activities in providing supports to the IPA’s provider network. This role involves collaborating with contracted providers to ensure comply with IPA and Health Plan standards.

*This is an in-person role that requires some travel in San Francisco and San Mateo County. Please see below for details.

Our Values:
  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence 
  • Be Innovative
  • Work As One Team


What You'll Do

  • Respond to provider inquiries via phone, email, or in person, in a timely and professional manner
  • Assist providers with billing questions, claim status, and account access issues
  • Communicate company procedures, updates, and compliance requirements to providers
  • Escalate complex issues to the appropriate internal departments for resolution
  • Document interactions and maintain accurate provider records in the system
  • Other duties as assigned


Qualifications

  • Must always have and maintain a reliable source of transportation
  • Associate's degree in healthcare administration, business, or a related field preferred
  • 1-2 years of experience in provider network management, or a similar role within the healthcare industry
  • Excellent written and verbal communication skills
  • Must be able to frequently travel to designated service regions as required
  • Proficient computer skills and Microsoft Office programs (i.e., Outlook, Excel, Word, and PowerPoint)
You're great for the role if:
  • You enjoy helping others by providing clear and friendly support
  • You’re a strong communicator who can explain processes and answer questions accurately
  • You work well both independently and collaboratively with internal teams
  • You’re adaptable and thrive in a dynamic environment, embracing change and continuous improvement


Environmental Job Requirements and Working Conditions

  • Our organization follows an in-person work structure where the expectation is to work in office and travel on a weekly basis.
  • This is a field representative position that requires travel to provider offices in San Francisco and San Mateo County. Travel is expected to be approximately 30% of your time, but it could vary depending on current projects or assignments. Anytime that you are not traveling, you will be working out of one of the two corporate office sites below.
    • Daly City office: 355 Gellert Blvd, S 200, Daly City, CA 94015
    • San Francisco office: 827 Pacific Ave, San Francisco, CA 94133
  • Work hours are Monday through Friday 8:30am-5:00pm PST. Occasionally required to work overtime and /or during the weekend.
  • The total compensation target pay range for this role is $28 - $33 per hour. The salary range represents our national target range for this role. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

A

Astrana Health, Inc.

Astrana Health is a physician-centric, technology-enabled healthcare company committed to delivering access to high-quality, patient-centered care. Through its proprietary end-to-end technology platform, Astrana empowers providers to deliver more proactive, preventive care - improving patient outcomes, elevating patient experiences, improving the well-being of providers, and driving greater value. Today, Astrana supports more than 20,000 providers and over 1.6 million Americans in value-based arrangements through its affiliated provider networks, management services organization, and primary, specialty, and ancillary care delivery clinics. Together, Astrana is building what our healthcare system should be - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com.
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