- Liaison between health plan and the participating providers
- Responds to provider needs and inquiries
- Provider education for office staff to include plan and benefit information, plan administration, and web portal assistance
- Create and distribute provider communication materials
- Collaboration and communication with other departments on provider issues, projects, and process implementation
- Participate in health plan audit preparation
- Maintain confidentiality of all patient information, as per HIPAA guidelines
- Maintain a full comprehensive understanding of the covered benefits, reimbursement policies, and contracts
- Ensure integrity of departmental database by thorough, timely and accurate entry, consistent with regulatory protocols and applicable Policies and Procedures
- Production and submission of reports as required
- Other duties, as assigned
- Develops provider communication materials such as provider notices, education materials, and manuals
- Statewide provider recruitment
- Functions as a provider specialist providing education and in-services via telephone or in-person when needed
- Ensures provider data accuracy
- Very strong written and verbal skills are required
- Establishes and maintains provider relationships
- Handles provider complaints and grievances from health plan partners
- Maintains and provides network adequacy reporting
- Assists other departments/teams as necessary
- Serves as a resource to others
- Proven, strong relationship builder/maintainer with internal clients and external providers, and have operational knowledge of managed care or healthcare plans
- Excellent interpersonal skills
- Excellent organizational skills
- Good analytical skills and the ability to problem solve creatively, objectively and rapidly
- A positive, flexible and self-motivated attitude, with superior teamwork skills in a multi-disciplinary environment
- Ability to work in a time sensitive environment
- Computer literate and proficiency in Microsoft Office and data management systems
- Strong understanding of health plan terminology required.
- Bachelor’s degree
- Ability to work independently
- Proficient experience using Microsoft office – Outlook, Word, Excel, and Power Point
- Some travel may be required
- Excellent oral and writing skills.
- Demonstrated ability to articulate goals, plan and implement processes, and meet deadlines.
- Advanced interpersonal skills.
- Experience with Optometry, Ophthalmology and or Podiatry specialties.
- Bilingual (English and Spanish) preferred.
At iCare Health Solutions we are a dedicated family of professionals with a strong desire to deliver quality services to our clients and their customers. We promote from within and offer internal advancement opportunities. For this role we offer a competitive pay rate and
benefits package. We provide the resources, training and support you need to be successful!
Our associates enjoy a fun and team oriented environment.
Other benefits of the CSR role include:
- Paid Time off program
- Paid Holidays
- 401(k) Retirement Plan with Company Match
- Healthcare Insurance
- Medical and Dental Insurance
- Short & Long Term Disability
- Life Insurance
Location: Tampa, FL
Schedule: Monday – Friday, various shift times