Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

 

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities

Acentra Health is looking for a Provider Relations Coordinator to join our growing team.

Job Summary:

The role of Provider Relations Coordinator holds a crucial position within the organization, employing specialized expertise in servicing provider questions and needs to ensure providers can operate effectively in the processes and systems we manage. Functioning as a vital liaison, this role actively contributes to recruitment endeavors and guarantees smooth communication between our team and providers. Attention to detail and adept multitasking skills stand as indispensable pillars, reinforcing our unwavering commitment to excellence in healthcare services.

Responsibilities:

Initiate effective outreach to client identified providers using various communication channels, including phone and email.Systematically track and document provider responses, assessing geographical coverage by percentage.Demonstrate expertise in articulating the Acentra Health onboarding and screening process, providing comprehensive information, and addressing queries from potential providers regarding required documents.Collaborate seamlessly with the enrollment team to ensure accurate and timely completion of all enrollment and screening documents.Drive onboarding and retention efforts for practitioners and provider organizations.Thoroughly review and prepare contracts for both practitioners and provider organizations, encompassing in-network and out-of-network agreements, including single-case agreements.Efficiently handle data entry tasks related to network information and contribute administrative support to the enrollment team.Serve as a liaison for resolving practitioner/provider issues during the enrollment process.Generate client reports pertaining to the network and ensure their accuracy and relevance.Efficiently handle incoming calls from clients and network providers, addressing inquiries related to client benefits, procedures, paperwork, payments, and other questions to resolve provider inquiries.Review provider appeals and apply knowledge of correct coding principals to resolve pricing and payment concerns.Respond to provider grievances and appeals related to claims payments and document outcomes and justification for appeal decisions.Maintain provider policy documentation and communicate changes to providers.Host training and webinars for providers to help them keep current on policies and changes and enable the providers to become self-sufficient using our systems and tools.Provide guidance to the technical teams to assist with correct configuration of new Medicare billing codes and methods.Proactively manage the customer service escalation phone queue, responding to inquiries and following up on provider inquiries left in the voicemail box according to established workflows.Maintain precise client records in the database by diligently entering all calls, case updates, requests, and referrals accepted by clients, following Acentra Health policies.Other duties as assigned to help internal and external customers achieve client program goals.Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.
Qualifications

Required Qualifications

High school diploma or equivalent (bachelor’s degree preferred)2+ years of provider-facing experience in healthcare (e.g., health plan/provider relations, medical billing, claims adjudication, or revenue cycle). Experience must include resolving provider inquiries about claims, pricing, and paymentsWorking knowledge of medical coding and claims fundamentals (e.g., CPT/HCPCS for procedures, ICD 10 for diagnoses; familiarity with EOBs/835/837 transaction concepts)Basic familiarity with Medicare/Medicaid payment rules relevant to provider claimsProficiency with Microsoft Office (Outlook, Excel, Word) and accurate data entry

Preferred Qualifications

Knowledge of Medicare Claims payment rulesClinical Coding CertificationClear ability to articulate the Acentra Health enrollment process and associated documents to potential providersExceptional organizational, verbal, and written communication skillsStrong negotiation and customer service abilitiesCapable of handling confidential business information and protected health information (PHI) with discretionEffective multitasking with the ability to manage several tasks simultaneously and meet deadlinesKeen attention to detail and organizational proficiencyProficient in reading and interpreting benefits and account information related to customized productsAbility to problem-solve, exercise judgment, and make independent decisions

 

Why us?

 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

 

We do this through our people.

 

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

 

Benefits

 

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

 

Thank You!

 

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

 

~ The Acentra Health Talent Acquisition Team

 

Visit us at https://careers.acentra.com/jobs

 

EEO AA M/F/Vet/Disability

 

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

 

Compensation

 

The pay range for this position is listed below. 

 

“Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

Pay Range

USD $23.42 - USD $29.28 /Hr.