Provider Inquiry Representative I

Martin's Point Health Care • Houston, TX

241d

About The Position

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of 'people caring for people,' Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a 'Great Place to Work' since 2015. The Provider Service Representative I's major responsibility is to professionally respond to telephone inquiries from providers & related entities. The questions will be concerning but not limited to benefits, eligibility, plan coverage, enrollment status, claims adjudication process, billing, and payments for Martin's Point USFHP Program and Medicare programs.

Requirements

• High school diploma or equivalent.
• 3 years of customer service experience.
• Terms of employment may require the applicant/incumbent to qualify, obtain and maintain a Position Level of Trustworthiness from the U.S. Government Office of Personnel Management.
• Additionally, this position may require the applicant/incumbent to be a U.S. citizen.

Nice To Haves

• Previous experience in a medical billing position preferred.
• Demonstrates an understanding of and alignment with Martin's Point Values.
• Excellent customer service skills.
• Ability to work efficiently and independently.
• Analytical skills in research and problem resolution.
• Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
• Ability to talk and type.
• Active Listener.
• Able to work cooperatively with other departments.
• Multi-task oriented with the ability to prioritize.
• Detail oriented.
• Well organized with excellent follow up skills.
• Ability to handle stressful situations and can easily adapt to change.

Responsibilities

• Answers verbal, written and electronic inquiries with complete and accurate information and educates when possible regarding Martin's Point USFHP and Medicare program's policies, procedures and self-service options.
• Responds to incoming inquiries and partners with provider on possible next steps and or resolution.
• Collaborates with PI Research team and or other departments when needed to resolve Provider issues.
• Follows up in a timely manner with providers when first call resolution is not possible.
• Stays educated on existing and new information available through Provider Services internal resources.
• Documents all provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry.
• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.

What This Job Offers

• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED