[Hiring] Provider Relations Billing & Education Representative @Accenture

Role Description

As 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 Responsibilities

• Act as a liaison between Medicaid Providers and MHP, ensuring smooth communication and resolution of any issues.
• Research, address, and resolve provider requests, questions, and concerns regarding Medicaid programs.
• Provide clear and actionable resolutions, offering root cause analysis for provider inquiries.
• Stay updated with MHP website education materials, basic portal knowledge, and problem-solving resources to support providers.
• Educate providers on policies, procedures, and billing processes related to Medicaid.
• Maintain a thorough understanding of Medicaid programs and regulations to ensure accurate and timely support for providers.
• Utilize available resources to perform thorough research and assist providers with timely solutions.
• Ensure all customer requests are handled effectively, maintaining high customer satisfaction.
• Meet all contractual obligations while fostering positive interpersonal relationships with program participants.
• Participate in scheduled meetings and events on time, managing time efficiently throughout the workday.
• Communicate consistently with internal teams, external providers, associations, and stakeholders about Medicaid policies and processes.
• Support ongoing efforts to improve the provider experience and resolve technology or process-related frustrations when necessary.
• Complete tasks and assignments in a timely manner while maintaining professionalism and a strong work ethic.
• Perform additional duties as assigned by management.

Requirements

• Reliable 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, Zapata.

Qualifications

• Minimum of 3 years of healthcare administration experience.
• Minimum of 1 year of experience in Medicaid, Medicaid Managed Care, and/or Health Plan Managed Care.

Preferred Qualifications

• Strong working knowledge of Medicaid Managed Care or commercial health plan managed care.
• Experience with billing in a hospital or healthcare setting.
• Project management experience is a plus.
• Proficiency in Microsoft Office, especially Word, Excel, and PowerPoint.
• Bachelor's degree in a related field.

Professional Qualifications

• Effective Communication: Ability to interact professionally with various stakeholders, including providers, internal teams, and external organizations.
• Time Management: Must be able to manage multiple tasks, attend scheduled events and meetings, and meet deadlines.
• Problem-Solving: Strong critical thinking skills to address provider concerns and resolve issues in a timely and efficient manner.
• Customer Service Orientation: A focus on maintaining high levels of customer satisfaction, especially when dealing with inquiries or frustrations.
• Attention to Detail: Accuracy in handling Medicaid policies, billing information, and other administrative duties.

Benefits

• Market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage.
• 401(k) plan.
• Bonus opportunities.
• Paid holidays and paid time off.