Provider Services Representative (Hybrid)
Village Care•New York, NY
•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.
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 skills
- Must reside within the New York Tri-State Area - NY, NJ, or CT.
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
Mid Level
Education Level
Associate degree
