Provider Network Relations Quality Specialist

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Job Summary:

This position is responsible for providing administrative support and maintaining all facility records within Acuity’s worldwide provider network. Strong documentation, interpretation, critical thinking, and follow-up are essential activities of this position. Daily interactions will include phone calls and email correspondence to facility staff members, and internal Acuity employees.

Whether the position or person is suitable for remote or hybrid work is based on the nature of the job duties, contract, and/or management’s discretion.

Duties and Responsibilities:

• Review, research, and respond to provider network requests submitted through the Provider Information Network System (PINS) ticketing system.
• Act as a liaison and prioritize resolution of facility invoice inquiries and invoice redirects.
• Effectively take ownership of managing individual workloads.
• Ensure ongoing provider network data accuracy through regular reconciliation of the Provider Information Network Systems (PINS).
• Participate in discussions to identify and offer potential solutions to complex issues.
• Prioritize and pivot with ease as directed by management when new tasks are assigned.
• Adhere to program specific protocols, processes, and policies.
• Meet or exceed established standards on a consistent basis for quality, customer service, productivity, and service level guidelines.
• Track provider network issues, progress and status for reporting to management.
• Professionally interact with all Provider Network departments in support of the medical examination line of business, and the maintenance of relationships with providers.
• Support Business Development by pulling network coverage reports and creating maps of our network based on client locations.

Qualifications:

• High School diploma with 1 year of relevant experience (provider relations, network management, customer service, or quality assurance) required.  
• Proven conflict resolution experience required.  
• Proficiency with computers and common office equipment, as well as with MS Office products required.   
• Must have excellent verbal and written communication skills 
• High level of organization, strong analytical/problem-solving, and attention to detail.

Preferred Qualifications:

• Associate degree with 2 years of relevant experience (provider relations, network management, customer service, or quality assurance) preferred.
• Medical, dental, or healthcare network and/or insurance experience preferred.

Physical Requirements and Work Conditions:

• Work is normally performed in a typical interior/office work environment. 
• Remote work requires dedicated office space.  
• Work involves sitting for prolonged periods of time.  
• May require bending and lifting up to 15 lbs. 

Acuity International is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, national origin, age, protected veteran status, or disability status.

For OFCCP compliance, the taxable entity associated with this job posting is:

Acuity-CHS, LLC