Provider Relations Billing & Education Field Representative

Provider Relations Billing & Education Field RepresentativeLocation: Rio Grande Valley of TexasAs a Provider Relations Billing & Education Representative, you will serve as a crucial liaison between Medicaid Providers and the Managed Health Plan (MHP). You will work closely with internal and external stakeholders, including provider group associations and various organizations, to provide guidance, resolve issues, and ensure smooth communication regarding Medicaid programs and policies.You will be responsible for assisting with provider enrollment, recruitment, and retention efforts while performing critical education and billing support. You will maintain a high level of professionalism, strong communication, and effective time management to ensure that all tasks and duties are completed on time and to the satisfaction of all parties.Key ResponsibilitiesAct as a liaison between Medicaid Providers and MHP, ensuring smooth communication and resolution of any issuesResearch, address, and resolve provider requests, questions, and concerns regarding Medicaid programsProvide clear and actionable resolutions, offering root cause analysis for provider inquiriesStay updated with MHP website education materials, basic portal knowledge, and problem-solving resources to support providersEducate providers on policies, procedures, and billing processes related to MedicaidMaintain a thorough understanding of Medicaid programs and regulations to ensure accurate and timely support for providersUtilize available resources to perform thorough research and assist providers with timely solutionsEnsure all customer requests are handled effectively, maintaining high customer satisfactionMeet all contractual obligations while fostering positive interpersonal relationships with program participantsParticipate in scheduled meetings and events on time, managing time efficiently throughout the workdayCommunicate consistently with internal teams, external providers, associations, and stakeholders about Medicaid policies and processesSupport ongoing efforts to improve the provider experience and resolve technology or process-related frustrations when necessaryComplete tasks and assignments in a timely manner while maintaining professionalism and a strong work ethicPerform additional duties as assigned by managementJob RequirementsReliable transportation for travel within the assigned territory - Rio Grande Valley of Texas Counties Served Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Starr, Webb, Willacy, ZapataBasic QualificationsMinimum of 3 years of healthcare administration experienceMinimum of 1 year of experience in Medicaid, Medicaid Managed Care, and/or Health Plan Managed CarePreferred QualificationsStrong working knowledge of Medicaid Managed Care or commercial health plan managed careExperience with billing in a hospital or healthcare settingProject management experience is a plusProficiency in Microsoft Office, especially Word, Excel, and PowerPointBachelor's degree in a related fieldProfessional QualificationsEffective Communication: Ability to interact professionally with various stakeholders, including providers, internal teams, and external organizationsTime Management: Must be able to manage multiple tasks, attend scheduled events and meetings, and meet deadlinesProblem-Solving: Strong critical thinking skills to address provider concerns and resolve issues in a timely and efficient mannerCustomer Service Orientation: A focus on maintaining high levels of customer satisfaction, especially when dealing with inquiries or frustrationsAttention to Detail: Accuracy in handling Medicaid policies, billing information, and other administrative duties