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Provider Relations Rep I

Company: Samaritan Health Services
Location: Corvallis
Posted on: July 30, 2022

Job Description:

JOB SUMMARY/PURPOSE Maintains positive public relations with provider groups, hospitals and clinic administrators across all business lines. Acts as a personal contact for training, materials distribution and as an information resource. Works throughout the Samaritan Health Plans service area to educate provider office staff on current coding and Samaritan Health Plans administrative and claims procedures. Serves as a resource for cross functional, problem-solving within the Provider Network Department. DEPARTMENT DESCRIPTION Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services# self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services# mission of Building Healthier Communities Together. EXPERIENCE/EDUCATION/QUALIFICATIONS Associate#s degree or equivalent experience required. One (1) year experience in a health care setting required. KNOWLEDGE/SKILLS/ABILITIES Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with operational areas within the organization, facilitate communication, and effectively document related activities. Excellent public relations skills. Ability to effectively explain administrative procedures to provider office staff of varying educational backgrounds and some familiarity with insurance billing. Ability to read, understand and communicate Samaritan Health Plans policy. Ability to identify problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions. Basic math skills including percentages, ratios and graphing. General computer, word processing and spreadsheet skills. General clerical skills. Ability to prioritize work. PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 # 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0#-36#) 0 - 20 Lbs LIFT (Knee to chest: 24#-54#) 0 # 20 Lbs LIFT (Waist to Eye: up to 54#) 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK # LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist

* JOB SUMMARY/PURPOSE
* Maintains positive public relations with provider groups, hospitals and clinic administrators across all business lines. Acts as a personal contact for training, materials distribution and as an information resource. Works throughout the Samaritan Health Plans service area to educate provider office staff on current coding and Samaritan Health Plans administrative and claims procedures. Serves as a resource for cross functional, problem-solving within the Provider Network Department.




* DEPARTMENT DESCRIPTION
* Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services' self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together.




* EXPERIENCE/EDUCATION/QUALIFICATIONS
* Associate's degree or equivalent experience required.


* One (1) year experience in a health care setting required.




* KNOWLEDGE/SKILLS/ABILITIES
* Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with operational areas within the organization, facilitate communication, and effectively document related activities. Excellent public relations skills. Ability to effectively explain administrative procedures to provider office staff of varying educational backgrounds and some familiarity with insurance billing. Ability to read, understand and communicate Samaritan Health Plans policy.


* Ability to identify problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.


* Basic math skills including percentages, ratios and graphing.


* General computer, word processing and spreadsheet skills. General clerical skills.


* Ability to prioritize work.




* PHYSICAL DEMANDS
* Rarely

(1 - 10% of the time)

Occasionally

(11 - 33% of the time)

Frequently

(34 - 66% of the time)

Continually

(67 - 100% of the time)

CLIMB - STAIRS

LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

LIFT (Knee to chest: 24"-54") 0 - 20 Lbs

LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

CARRY 1-handed, 0 - 20 pounds

BEND FORWARD at waist

KNEEL (on knees)

STAND

WALK - LEVEL SURFACE

ROTATE TRUNK Standing

REACH - Upward

PUSH (0 - 20 pounds force)

PULL (0 - 20 pounds force)

SIT

CARRY 2-handed, 0 - 20 pounds

ROTATE TRUNK Sitting

REACH - Forward

MANUAL DEXTERITY Hands/wrists

FINGER DEXTERITY

PINCH Fingers

GRASP Hand/Fist

Keywords: Samaritan Health Services, Corvallis , Provider Relations Rep I, Other , Corvallis, Oregon

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