Job Title/Position: Provider Relations Clerk

Job Classification: Administrative/Professional Support

Date of Analysis: Date of Revision/Review: 06/07/2022

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Brief Description of Job Responsibilities:

Provide support in the maintenance of provider and payer credentialing data. Communicate via phone and e-mail with internal and external parties to provide requested data on behalf of Prevea Provider Relations and providers. Supports the Provider Relations department as needed.

Specialized Responsibilities:

(This list may not include all the duties assigned)

• Respond promptly to requests for provider data via phone, e-mail, fax, interoffice mail, etc. from internal and external parties. Data will be items such as, NPI, license, DEA, malpractice, Continuing Medical Education (CME) certificates, and any other expirable data stored in provider files within Provider Relations.
• Provide telephone/fax coverage for the Provider Relations d Assists callers with provider verification for members, providers, and payers.
• Receive and route internal and external daily paper mail to appropriate locations.
• Back-up support for credentialing, re-credentialing, and payor enrollment
• Enter miscellaneous information in databases and file hard copies in provider files to maintain high department quality.
• Support and comply with department and clinic policies, procedures, objectives, quality assurance, safety, and environmental and infection control.
• Assists in special projects as needed.
• Regular and reliable attendance.
• Attend meetings as required by the department.
• Enhance professional growth and development through attendance at Prevea sponsored opportunities.

Performance Requirements:

Excellent organizational, communication and customer service skills. Ability to juggle several different tasks while remaining calm and professional. Ability to be tactful and discreet when dealing with confidential information. Strong knowledge of computer systems and applications. Excellent command of English grammar, spelling, and punctuation. Strong skills in written and verbal communication. Knowledge of basic arithmetic to make calculations. Ability to gather and report information. Ability to work effectively with all levels of staff, patients, public, external agencies, and particularly senior management. Ability to be flexible and adaptable.

Education/Experience/Certifications:

High school education required.

Non-Essential Duties:

Typical Working Conditions:

Work is performed in an office environment. Involves frequent contact with senior management staff, physician shareholders and the public. Frequent telephone contacts with employees and patients. Work may be stressful at times. Interaction with others is constant and interruptive. Some travel between clinic sites may be necessary.

Typical Physical Demands:

Requires prolonged sitting, some bending, stooping, and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment. Requires vision correctable to 20/30 and hearing within normal range to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 50 pounds occasionally. Requires dexterity to type 60wpm. May be necessary to view and type on computer screens for long periods.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify

Essential Functions/Physical Demands

Job Title/Position: Provider Network Associate

Job Classification: Administrative/Professional Support

Frequency of activity required to perform the job

Never

(0% of work day)

Seldom

(1-10% of work day)

Occasional

(11-33% of work day)

Frequent

(34-66% of work day)

As Required

( Greater than 67% of work day)

Physical Requirements

Sit

x

Stand

x

Walk

x

Drive

x

Climb (Stairs/Ladders)

x

Bend (Neck)

x

Bend (Waist)

x

Squat

x

Kneel/Crawl

x

Twist/Turn (Neck)

x

Twist/Turn (Waist)

x

Lift/Carry 0-10 lbs.

x

Lift/Carry 11-25 lbs.

x

Lift/Carry 26-35 lbs.

x

Lift/Carry 36-50 lbs.

x

Lift/Carry 51-75 lbs.

x

Lift/Carry 76-100 lbs.

x

Lift/Carry > 100 lbs.

x

Push/Pull up to 10 lbs.

x

Push/Pull 11-25 lbs.

x

Push/Pull 26-35 lbs.

x

Push/Pull 36-50 lbs.

x

Push/Pull 51-75 lbs.

x

Push/Pull 76-100 lbs.

x

Push/Pull > 100 lbs.

x

Reach (Above shoulder level)

x

Reach (Below shoulder level)

x

Simple Grasping (Hands/Arms)

x

Fine Manipulation (Hands/Arms)

x

Gross Manipulation (Hands/Arms)

x

Vision Requirements

Color Discrimination

x

Near Vision (Correctable to Jaeger 2 or 20/30 binocular)

x

Distance Vision (Correctable to Snellen chart 20/30 binocular)

x

Hearing Requirements

Hears Whispers < 3 feet

x

Hears Whispers 3-8 feet

x