Provides exceptional service and support to all providers/locations through execution of provider/location database requests within established performance metrics.
• Receives, researches and processes provider/location requests related to additions, changes and terminations and ensures all requests are logged in appropriate database for performance measurement. Changes could consist of:
address changes, payment changes, doctor transfers, plan participation changes, business ownership
• Evaluates, researches and resolves complex provider data maintenance requests and issues. Understands the systems, business process and provider impact of alternative set-ups.
• Assist management with database / data integrity issue research and recommends resolutions. Identifies trends related to data structure/set up and reports trends with proposed solutions to management.
• Identifies opportunities to improve processes to ensure efficient turnaround of issues and meets and exceeds established deadlines and performance standards.
• Responds to telephone calls, emails, and written requests from providers/locations as well as internal departments related to provider/location set up in system.
• Ensure efficient, accurate and timely responses to provider requests related to participation in the panel.
• Distribute provider/location contracts and follow up to ensure all appropriate contracts are executed prior to provider/location participation on a panel.
• Assists in ensuring all appropriate documentation is maintained in document management application.
• Meet Performance and Quality metrics.
• Implement / participate in other Provider Relations team projects as requested
Minimum (Required) Qualifications:
• High School Diploma required, Associate or Bachelor Degree preferred
• 1-2 years of experience in Customer service and/or data analysis experience
• Proficient with Microsoft Office (Word and Excel)
• Strong critical thinking skills
• Problem solving skills/Decision Making abilities
• Manage time and multiple tasks effectively
• Ability to handle escalated provider issues, including direct provider calls.
• Developed oral/written communication skills
A little about us:
We partner with people to improve skills, teams and lives every day, and we help them achieve more than they ever thought possible.