Provider Partnership Assoc

• Independently researches, analyzes, and addresses provider issues and concerns to achieve expected goals/outcomes

• Proactively educates providers on new initiatives and policy changes that impact their claims payments, including

• Establishes and maintains professional and effective relationships between IBC and network providers to continually

• Ensures the resolution to issues related to complex claims payment, provider data file maintenance, Quality Incentive

• Maintains and updates the appropriate tracking issues database with current statuses and next steps.
• Collaborates with other departments within the organization to assist with resolution of complex provider issues.

Qualifications
The candidate must have a bachelor’s degree or equivalent work experience.
Minimum five years’ progressive experience in a health-care related organization is required, with experience in Provider
Networks, Contracting, Claims Processing or Managed Care Operations strongly preferred.
Knowledge of professional billing requirements, reimbursement methodology, IBC/AmeriHealth products, medical policy,
and benefits.
Proficiency with Word, Excel, Access, and Outlook.
Experience using multiple IBC systems, Navinet, and the suite of Highmark applications including but not limited to:
INSINQ, OCWA, OSCAR, 4UM, 310 Database, Provider Profiles, and PGRS.
Proven ability to conduct educational programs using a multi-media approach to small and large groups.
Prior experience in a service-oriented role strongly preferred.
The candidate must be self-motivated with strong interpersonal, analytical, problem-solving, organizational, time
management, and written and verbal communications skills.
Ability to independently manage multiple priorities with varying levels of complexity and customer expectations to
a successful conclusion with limited supervision is essential, as is the ability to interact effectively with all levels of
management, including medical directors.
Hybrid of Choice:
Independence has implemented a “Hybrid of Choice” model which provides our associates with the flexibility to choose
whether to work remotely, work in the office every day, or work in the office on certain days at their discretion. However,
management may require our associates to work from Independence’s physical office locations on certain occasions.
This role is designated as a role that fits into the “Hybrid of Choice” model. While associates may work remotely, the
work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.