Provider Relations Representative

Valenz • Phoenix, AZ

7d • Remote

About The Position

As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—or customer love as we say!

Requirements

• 1+ years of experience in customer service.
• Experience working independently and completing assignments within given instructions, routines, and accepted practices.
• Excellent verbal and written communication skills.
• Ability to work in a fast-paced, customer focused, and deadline-driven environment.
• You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Nice To Haves

• Experience working in healthcare environment with providers.

Responsibilities

• Facilitate inquiries from providers regarding reimbursement rates.
• Negotiate ongoing and single case agreements (SCAs)
• Direct members to in-network or RBP accepting providers.
• Focus on the member journey and minimizing disruption to providers.
• Develop trust with members and providers to ensure long-term relationships.
• Anticipate and identify issues and escalate to the appropriate manager or team leader.
• Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn-around-times, and success rates.
• Facilitate the appeals process.
• Maintain compliance with company policies and procedures.
• Performs related duties as assigned by supervisor.
• Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 251-500 employees