Job Details

Provider Relations Coordinator

  2024-10-03     Calvo's Insurance Underwriters     P.O. Box CI, Hagatna  
Description:

Nature of Work

Under the direct supervision of the Health Plan Administrator, this role serves as the liaison between the health plan and providers to coordinate the negotiation of contracts and support the provider credentialing activities.​

Essential Duties and Responsibilities 

  • Establishes and maintains positive relationships with healthcare providers by collaborating on periodic onsite visits, providing ongoing education, communicating administrative updates in a timely manner.
  • Engages with providers and stakeholders to promptly resolve issues with a high level of customer service.
  • Coordinates with department managers to promptly resolve provider issues related to billing, payments, claims denials, authorizations.
  • Coordinates the negotiation of provider contracts and related credentialing activities with the plan administrator.
  • Performs other related duties as assigned.​

Position Requirements

  • ​​Associate's Degree in Business or Healthcare, or a related field preferred.
  • Minimum 5 years practical experience in project management and/or contract negotiation.
  • ​Intermediate proficiency with Microsoft Office programs.
  • Excellent communication skills with the ability to develop, collaborate, and maintain effective working relationships with providers and internal and external stakeholders.
  • Ability to work effectively and efficiently in a fast-paced environment, handling multiple tasks, and meeting established timelines.
  • Ability to work independently with a strong attention to detail.


Do not contact this company in solicitation of any product or service.

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