Our client, a growing healthcare services company, is hiring in their Provider Relations

Department. The role, a Senior Provider Relations Representative, will handle escalated matters

and work hand-in-hand with the current Team Lead as they train towards assuming that position.

The Provider Relations Team is responsible for the contracting of medical providers for self-funded

healthcare plans (knowledge of RBP a plus). We are looking for someone who has a clear and

thorough understanding of how medical insurance works, has prior experience with medical billing,

and is comfortable reaching out to provider offices to discuss various plan designs and negotiate

terms of Single Case Agreements.

Position Overview

- Negotiate provider arrangements based on member requests
- Resolve any issues from contracted and participating providers
- Work collaboratively with internal departments and business partners
- Handle escalated matters and be a resource for team members




- Monitor chat channels and email inboxes
- Perform all other projects and duties as assigned

Requirements

- Strong contract negotiation skills
- Ability to use sound judgment to resolve complex issues and escalations
- Understand the importance of follow-up and follow-through
- Confident phone skills
- Energetic team player who is receptive to feedback
- Excellent verbal and written communication skills
- Comfortable working independently in a high-volume, fast-paced environment with the
- ability to multitask
- High work ethic and attention to detail
- Ability to meet goals and urgent deadlines with critical thinking approaches
- Experience with health insurance/medical offices, CPT knowledge a must
- Abide by HIPAA guidelines
- Excellent Computer Skills and knowledge

#J-18808-Ljbffr

📌 Senior Provider Relations Representative (Medellín)
🏢 KMC Solutions
📍 Medellín