PPO Provider Relationship Specialist
About Our Company
At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. Doctors today are faced with the reality of spending more time on administrative tasks than caring for patients. Physician burnout and fatigue are an epidemic, and the healthcare experience and quality suffer as a result. At Altais, were building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include: Brown and Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists.
About Your Team
Are you looking to work with a high performing, fast growing PPO team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.
About Your Work
The PPO Provider Relationship Specialist is responsible for managing and enhancing relationships with providers to ensure high-quality service delivery and provider satisfaction. This role serves as the primary person of contact between the organization and providers, addressing inquiries, resolving issues, and facilitating communication to improve overall provider experience.
Essential Functions:
Maintain accurate records of provider interactions, feedback, and resolutions in the CRM system
Identify and address issues faced by providers, working to resolve problems efficiently and effectively while ensuring provider satisfaction.
Identifying trends and opportunities for improvement.
Work closely with internal teams (e.g., Operations, Provider Reps, and Customer Service) to align efforts and improve provider relations strategies.
Work closely with our contracted Health Plans
The Skills And Experience You Bring:
Resolve CRMs within established Turnaround time
Ability to research issues and follow up with provider or Customer Service within the established turnaround time measures and escalate complicated issue to appropriate persons
Demonstrate ability in oral and written communications, professional approach to problem resolution and organizational skills.
Demonstrated ability to work as an effective team member always recognizing the need for a positive way.
Education/Experience: High school Diploma or G.E.D and equivalent of 5 years of relevant experience in PPO claims, billing cycle, and/or provider relations
5+ years of Provider Relations
5+ years of Professional billing setting or Revenue Cycle management in an IPA
5+ years of knowledge of Claim Clearing house management, i.e. Change Health
5+ years of understanding and application of ICD-10, RVS, CPT codes, basic medical terminology.
You Share Our Mission & Values:
You are passionate about improving the healthcare experience and want to be part of the Altais mission.
You are bold and curious- willing to take risks, try new things and be creative.
You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.
Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidates starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidates qualifications, skills, and experience.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our CPRA Privacy Notice for California Employees and Applicants to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork Activity level: Sedentary, frequency most of workday.
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
Apply Now
At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. Doctors today are faced with the reality of spending more time on administrative tasks than caring for patients. Physician burnout and fatigue are an epidemic, and the healthcare experience and quality suffer as a result. At Altais, were building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include: Brown and Toland Physicians, Altais Medical Group Riverside, and Family Care Specialists.
About Your Team
Are you looking to work with a high performing, fast growing PPO team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.
About Your Work
The PPO Provider Relationship Specialist is responsible for managing and enhancing relationships with providers to ensure high-quality service delivery and provider satisfaction. This role serves as the primary person of contact between the organization and providers, addressing inquiries, resolving issues, and facilitating communication to improve overall provider experience.
Essential Functions:
Maintain accurate records of provider interactions, feedback, and resolutions in the CRM system
Identify and address issues faced by providers, working to resolve problems efficiently and effectively while ensuring provider satisfaction.
Identifying trends and opportunities for improvement.
Work closely with internal teams (e.g., Operations, Provider Reps, and Customer Service) to align efforts and improve provider relations strategies.
Work closely with our contracted Health Plans
The Skills And Experience You Bring:
Resolve CRMs within established Turnaround time
Ability to research issues and follow up with provider or Customer Service within the established turnaround time measures and escalate complicated issue to appropriate persons
Demonstrate ability in oral and written communications, professional approach to problem resolution and organizational skills.
Demonstrated ability to work as an effective team member always recognizing the need for a positive way.
Education/Experience: High school Diploma or G.E.D and equivalent of 5 years of relevant experience in PPO claims, billing cycle, and/or provider relations
5+ years of Provider Relations
5+ years of Professional billing setting or Revenue Cycle management in an IPA
5+ years of knowledge of Claim Clearing house management, i.e. Change Health
5+ years of understanding and application of ICD-10, RVS, CPT codes, basic medical terminology.
You Share Our Mission & Values:
You are passionate about improving the healthcare experience and want to be part of the Altais mission.
You are bold and curious- willing to take risks, try new things and be creative.
You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
You co-create, knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.
Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidates starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.
The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidates qualifications, skills, and experience.
Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our CPRA Privacy Notice for California Employees and Applicants to learn how we collect and process your personal information when you apply for a role with us.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork Activity level: Sedentary, frequency most of workday.
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
Apply Now