Description:
- Support the Provider Relations Field Representative to achieve department goals
- Answer incoming telephone inquiries from providers and assist with problem resolution of issues
- Coordinate submission of provider to internal departments via contract maintenance forms
Key Duties and Responsibilities:
- Support the Provider Relations Field Reps to resolve claims and payment issues
- Answer incoming telephone inquiries from providers and assist with problem resolution of issues
- Root cause analysis of operational and health services issues
- Review and process incoming and outgoing paperwork, including directory updates, provider credentialing applications, contract maintenance forms and other related forms
- Track new contracts through sidewinder
- Audit configuration loads on new contracts
- Provide office, project management, provider recruitment and data analysis support
- Perform special projects as assigned or directed
Education:
- A High School diploma or GED (required)
- An Associate degree in a related field (preferred)
Work Experience:
- 1+ year of experience in customer service or claims with exposure to problem resolution
Skills:
- Demonstrated problem solving skills
- Demonstrated interpersonal/verbal communication skills
- Demonstrated written communication skills
- Demonstrated organizational skills
- Demonstrated time management and priority setting skills
- Demonstrated analytical skills
Technology Proficiency:
- Microsoft Outlook
- Microsoft Word
- Microsoft Excel
- SalesForce
- Sidewinder
Level of Supervision Received:
- Under general supervision, proceed alone on regular duties, referring questionable cases to supervisor