Title:  Provider Relations Representative II

Division:  Patient Business Services
Schedule:  Monday to Friday 8 a.m. to 5 p.m.
Work Location:  Houston, TX
Salary Range:  $46,176 to $63,723
FLSA Status:  Exempt
Requisition ID:  12454

Summary

The position is a liaison between the BCM credentialing team and managed care companies. By reviewing patient accounts the representative will identify and fix obstacles to ensure payment. By addressing enrollment issues, managed care hurdles and other issues, the team member helps to increase revenue while reducing costs. 

Job Duties

Reviews open accounts referred by the follow-up section.
Identifies credentialing or managed care issues in the data.  Work with appropriate PBS section to resolve issues.
Tracks credentialing workflow to write off balances prior to enrollment with managed care plans and to identify errors in onboarding.
Reviews credentialing databases to identify taxonomy errors, delays in onboarding and account balances
that were generated prior to the provider's effective date.
Prepares monthly reports of accounts receivable for both FGP and AMS that are unpaid because of credentialing issues.
Prepares accounts for outside counsel to review.
Writes off outstanding balances that are related to credentialing/enrollment and are not recoverable.

Minimum Qualifications

  • Bachelor's degree in healthcare, management, business or related field. Four years of relevant experience may substitute for degree requirement.
  • Three years of relevant experience.

Preferred Qualifications

  • Experience within a revenue cycle.
  • Ability to critically analyze data.
  • Able to work independently.

 

 

Baylor College of Medicine requires employees to be fully vaccinated -subject to approved exemptions-against vaccine-preventable diseases including, but not limited to, COVID-19 and influenza.

 

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.

 12454

CA