Provider Relations Executive

About the role

The Provider Relations Executive assists in managing relationships between healthcare providers and the Health Maintenance Organization (HMO). The role supports the onboarding process, coordinates communication between providers and HMO teams, addresses provider inquiries and helps resolve issues related to claims, billing or care delivery. It works closely with the Provider Relations Manager so that providers are well informed and supported.

Key responsibilities

• Serve as a point of contact for providers, answering inquiries and keeping them informed of HMO policies, procedures and updates
• Resolve provider issues related to claims, billing or service delivery
• Assist in onboarding new providers and help coordinate training sessions on HMO policies and procedures
• Support providers in resolving claims and billing issues and act as a liaison with the claims department
• Monitor provider performance, gather feedback and prepare performance and satisfaction reports for management
• Handle company information confidentially, follow information security guidelines and report suspected data breaches
• Carry out other duties assigned by the company, take part in the department's knowledge-sharing programme and support the Managing Director and Vice Chairman as required

Required profile

• Bachelor's degree in Healthcare Administration, Business or a related field
• Minimum of 2 years of experience in provider relations, healthcare administration or customer service within an HMO environment

Required skills

• Strong communication and interpersonal skills
• Problem-solving ability to handle provider issues
• Knowledge of healthcare billing and claims processes
• Customer-service mindset focused on provider satisfaction