Provider Services Representative (Hybrid)
About The Position
VillageCareMAX is looking for a motivated individual for this Full Time role as the Provider Services Representative. This role is the primary point of contact between VillageCareMAX and contracted and/or non-contracted providers for our MLTC and Medicare lines of business for submitting Organization Determination requests. Some of your daily activities will include: Supporting our Utilization Management team and Member Experience team by maintaining incoming service requests to the department. Adhere to call center KPI requirements and Quality Assurance guidelines. Handle incoming requests from providers via ACD Calls and Faxes for compliance timeframes as well as performing outbound calls as needed to provide a first call resolution. Initiates Organization Determination requests upon requests from providers. Data enters authorizations under the direction of the Interdisciplinary Care Team when needed. We would like to speak to those who have an Associate degree or bachelor's degree in a related field along with 2+ years practical experience in healthcare setting. Excellent communication skills, organizational skills and problem solving will be vital to this position. Must reside within the New York Tri-State Area - NY, NJ, or CT.
Requirements
- Associate degree or bachelor's degree in a related field
- 2+ years practical experience in healthcare setting
- Excellent communication skills
- Organizational skills
- Problem solving
Responsibilities
- Supporting our Utilization Management team and Member Experience team by maintaining incoming service requests to the department.
- Adhere to call center KPI requirements and Quality Assurance guidelines.
- Handle incoming requests from providers via ACD Calls and Faxes for compliance timeframes as well as performing outbound calls as needed to provide a first call resolution.
- Initiates Organization Determination requests upon requests from providers.
- Data enters authorizations under the direction of the Interdisciplinary Care Team when needed.
Benefits
- PTO package
- 10 Paid Holidays
- Personal and Sick time
- Medical/Dental/Vision
- HRA/FSA
- Education Reimbursement
- Retirement Savings 403(b)
- Life & Disability
- Commuter Benefits
- Paid Family Leave
- Additional Employee Discounts
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
