Job Description

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here.

What awaits you:

• Work-life balance - This is a hybrid role. Must work one day per month in our Hanover, MD location.
• Great hours- Monday-Friday 8am-4:30pm
• Medical, Dental, and Vision Insurance.
• 403B Savings Plan w/employer contribution.
• Paid Time off & Paid holidays.
• Employee and Dependent Tuition assistance benefits.
• Health and wellness programs and MORE!

Please note : US citizenship is required for this position as it falls under the terms of a government contract (to ensure compliance with DODPSP).

Who you are:

As a Provider Relations Coordinator for Johns Hopkins Health Plans, you are the go-to for our providers when it comes to everything from eligibility, appeals process, and most importantly, complex claims resolution.

What you’ll do:

• Provider Relations administrative and operational duties:
  • Complex claim research and resolution
  • Supporting Customer Service with calls as needed
  • Network Maintenance regarding claim payment
  • Eligibility
  • Benefit interpretations
  • Referral and appeals process
  • Provider contract discrepancies
  • Provider portal questions
  • Provider Credentialing Process related to applications and documentation as well as inbound and outbound communications
• Provider Education and Communication
• Department projects and meetings

What you’ll bring:

• 3+ years’ current experience in managed care or medical billing experience
  • Claims experience
  • Experience within a provider portal also highly preferred
• Our ideal candidate will have proficient PC skills to include experience in healthcare databases- Epic, Facets, HealthSuite, Excel.
• Excellent written and oral communication skills.
  • Excellent interpersonal skills are required in relating to providers or business associates in all type of situations.
• Strong analytical ability to gather and interpret data from different sources and to resolve moderately complex problems.
• High School Diploma, or equivalent
  • Associates degree preferred.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home.

Salary Range: Minimum 22.00/hour - Maximum 36.32/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!

Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

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