Provider Relations Rep Cover Letter

I submit this application to express my sincere interest in the provider relations rep position.

Previously, I was responsible for national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Knowledge of medical terminology, medical policy and benefit knowledge
• Experience with electron health record and electronic medical record software systems
• Knowledge medical terminology, medical billing, medical offices procedures
• Differentiate between allowable, Medicaid, and billed fees and reimbursement levels in each market
• Typing helpful
• Physician office operations experience
• Experience in provider relations, network management, and/or provider customer service in a managed care environment
• Experience in managed care contracting, contract review, tracking, and maintenance

In response to your job posting for provider relations rep, I am including this letter and my resume for your review.

In the previous role, I was responsible for support for Provider Relations representatives in regards to claims research and assists in provider inquires and information changes, as needed.

Please consider my experience and qualifications for this position:

• Knowledge of medical and managed care terminology
• Knowledge of physician practice patterns, managed care contracting and health plan operations in the local market
• Administrative Support – Obtain, process, manage and maintain both hard-copy and computer based provider information necessary for network development and maintenance activities
• Process incoming Exhibit As – Contracted Sites for newly implemented services, newly implemented address changes
• Answer practitioner/facility recruitment questions regarding joining Beacon’s network
• Participate in regularly scheduled meetings with other departments
• Composes written educational materials, such as newsletters, and contract summations for clinical departments, operational departments, and physicians
• Develops operational plans, policies and procedures for the Contracting and Revenue Cycle Management Department

I submit this application to express my sincere interest in the provider relations rep position.

In the previous role, I was responsible for escalated support to the provider community and the Department of Health regarding NY Medicaid claims billing questions or issues.

Please consider my qualifications and experience:

• Educates facility departments regarding changes in policies and procedures for admitting, billing, and reimbursement on all managed care strategies and contracts
• Assists in the independent follow-up with medical staff on revenue cycle initiatives
• Functions as the liaison and contact person to operations staff of admitting and business offices, case management, clinical departments, and contracted health plans
• Supports Customer Service and other Business Office staff responding to both payer and patient inquiries regarding patient accounts