Senior Provider Services Representative (Hybrid)

Village Care•New York, NY

4d•Hybrid

About The Position

VillageCareMAX is looking for a motivated individual for our Senior Provider Services Representative position. This critical role is responsible for ensuring the efficient and effective operation of the Provider Services team. It involves deep investigation into provider-related issues, handling escalation calls, and acting as a liaison with claims vendor call center queues. The Senior Provider Service Representative will serve as an escalation channel and will support departments by maintaining incoming service requests.

Requirements

Associate degree, Bachelor's highly preferred
2+ years practical experience in healthcare setting
3-5 years customer service experience required with a track record of handling complex issues.
Ability to work in a collaborative, fast-paced, dynamic environment will be essential to this role.

Responsibilities

Conduct thorough investigations into complex provider-related issues.
Handle escalated calls from providers, addressing their concerns and issues in a professional and timely manner, striving to achieve satisfactory resolutions.
Assist supervisor with training, mentoring, and trend analysis.
Maintain accurate and detailed records of provider interactions, investigations, and resolutions in the Organization's EMR.
Ensure that all provider interactions adhere to the Organization's quality standards and regulatory compliance.
Collaborate with Supervisor and relevant departments to identify and implement process improvements that enhance the efficiency and effectiveness of provider services.