Job Description
Provider Relations Rep I (Remote, $14.50/hour)
Administrative
Remote, United States
American Specialty Health Incorporated is searching for an exceptional customer service representative to join our Provider Relations Team. The ideal candidate will professionally respond to practitioner inquires via the telephone queue system regarding credentialing, re-credentialing and contracting to ensure efficient and effective resolution of practitioner inquires or complaints and to deliver high quality customer service.
Remote Worker Considerations
Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 50 Mbps upload speed).
Responsibilities
- Answers incoming calls in a professional, accurate, timely and courteous manner from the Provider Relations and Credentialing queue.
- Assists practitioners, staff, and clients with questions regarding credentialing, re-credentialing, participation requirements, contractual issues and high-level administrative problems.
- Performs credentialing and re-credentialing activities according to plan specifications.
- Forwards complex requests that require research to the appropriate ASHCore bucket or PRL supervisor to achieve appropriate resolution.
- Captures practitioner complaints and resolves or forwards to the appropriate ASHCore bucket or PRL supervisor for resolution.
- Captures practitioner change information, documents and forwards as required to record changes in appropriate databases.
- Handles necessary administrative duties to properly support, document and resolve practitioner inquires.
- Maintains confidentiality of practitioner files, participation data, practitioner records/documents and all discussions relative to recruiting, contracting, and credentialing processes.
- Attends department and all-staff meetings to increase knowledge and foster teamwork.
- Pull CAQH applications when provider calls in with CAQH number. Drop application in designated folder.
- Download CAQH applications for PTOT practitioners that are being added to a provider.
Qualifications
- Associate’s degree or equivalent preferred. High school diploma required.
- Minimum two years of progressive experience performing customer service duties preferred.
- Specialty health care or health care experience preferred.
- Credentialing and re-credentialing experience preferred.
- Proficient in MS Office with experience in word processing and spreadsheet applications.
- General understanding of Provider Relations Guidelines.
Core Competencies
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Ability to effectively organize, prioritize, multi-task and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters.
Mobility
Primarily sedentary, able to sit for long periods of time.
Physical Requirements
Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.