Provider Relations - Manager

EXL is looking for a Provider Relations Manager. This is a remote work from home opportunity in the US!

Job Summary:

The Provider Relations Manager will be responsible for managing provider relations and service interactions within their assigned team. Acting as a key liaison, this individual will support external providers with audit inquiries, claims reimbursement progress, and training on portal navigation and service enhancements. The role also involves guiding providers on claim audit record submissions, timelines, and process adherence.

The ideal candidate will be adept at identifying operational gaps, resolving complex claims issues, and effectively communicating solutions. This role is critical in fostering and maintaining strong relationships between EXL and our valued providers while ensuring exceptional service and satisfaction.

Key Responsibilities:

• Serve as the primary contact for provider audit inquiries, claims reimbursement progress, and service-related concerns.
• Provide training and education on claims audit record submissions, timelines, and process guidelines.
• Assist providers in optimizing portal usage and understanding service enhancements.
• Identify and address operational inefficiencies while implementing data-driven solutions.
• Research and resolve complex claims issues, ensuring timely and effective communication of resolutions.
• Collaborate with internal teams to improve tools, resources, and provider support systems.
• Utilize business knowledge and sound judgment to navigate ambiguous situations and address non-standard requests.
• Build and maintain strong provider relationships, ensuring their needs are met while aligning with company policies.
• Contribute to the success of the Provider Touch Team by fostering collaboration and enhancing the overall provider experience.

Preferred Qualifications:

• 4+ years of experience in healthcare or managed care settings.
• 3+ years of direct provider-facing experience.
• Intermediate knowledge of claims processing and auditing.
• Strong background in claims processing.
• Solid understanding of healthcare operations and industry best practices.
• Proficiency in PC skills and data software applications.

Professional Qualifications

• Outstanding interpersonal skills with the ability to build rapport and maintain positive relationships.
• Strong customer service mindset with a solution-oriented approach.
• Excellent verbal and written communication skills.

What We Offer:

At EXL, we provide a dynamic, fast-paced, and innovative environment where entrepreneurial professionals can make a significant impact.

• Work closely with world-class healthcare consultants from day one.
• Gain exposure to various aspects of our clients' businesses while developing key teamwork and time-management skills.
• Benefit from our structured mentoring program, where junior employees receive guidance from senior professionals.
• Experience limitless growth opportunities within EXL and beyond.
• Comprehensive benefits package including Healthcare, Vision, Dental, and 401(k) options.

Join EXL Health and be part of a team that is redefining provider relations in the healthcare industry!

Apply Today!