Specialist, PR Internal (Job ID: 934)

Posted: 07/12/17 | SHARE:


Interacts with providers and internal departments by phone and in writing. Maintains provider files in the form and manner prescribed by internal policy and procedures. Specific duties include but are not limited to: Management of provider demographic information. Responsible for all departmental clerical functions including scanning and filing all correspondence and documentation. Complete Mid-Level Registrations. Performs monthly sanction checks for registered mid-levels and physicians. Conducts provider inactivation/terminations and coordinate resulting member notification process in conjunction with the Customer Care Center. Performs Quality Checks on provider demographic changes and terminations. Performs Regulatory Reviews/Updates including but not limited to HPN, Medicaid ID#’s, missing information from state, provider licenses, provider directory collaboration/proofing. Provides follow-up requests for information to provider offices and to Provider Relations Representatives when documentation is missing from demographic correspondence. Answers departmental phones responding to provider inquiries and escalating issues as appropriate. Responsible for distributing inquires received by providers from the mvphealthcare.com and hudsonhealthplan.org site to appropriate region/representative. Assist Sr. Internal PR specialists with Access & Availability, directory studies, issue resolution, and special projects, claims research, and complex issues.


Minimum Education:
Associates Degree or high school diploma with equivalent combination of experience considered.

Minimum Experience: 

1-2 years’ work experience.

Required Skills:
• Excellent written communication skills and proficiency with Word and Excel.
• Excellent general computer skills with ability to work in multiple systems effectively.
• Strong Interpersonal skills and ability to work independently.
• Strong organizational, time management, oral, written and communication skills.
• Must have a high degree of personal initiative and ability to work independently.
• A team player able to work well in an energetic, dynamic and deadline oriented environment.
• Orientation towards public relations with excellent verbal (strong professional phone skills required) and written communication.
• Familiarity with medical terminology.

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