Provider Support Representative

Job Highlights

Using AI ⚡ to summarize the original job post

Responsibilities

• Champions a customer focused culture to deepen client relationships.
• Understands how Health New England’s culture and the CX Promise should be considered in day-to-day activities and decisions.
• Actively pursues effective and efficient operations of their respective areas in accordance with Health New England’s Values, Code of Conduct, and Associate Handbook.
• Champions a high performance environment and contributes to an inclusive work environment.
• Accepts inbound calls and email inquiries/requests from providers and responds according to established processes and procedures.
• Employs online resources to ensure consistent and accurate information is relayed to providers.
• Researches low to medium complexity issues using established protocols and communicates to providers using approved media and standards.
• Follows established processes and procedures for addressing or reassigning provider inquiries, requests, or grievances.
• Identifies escalated issues and leverages the Provider Support team and other HNE functional areas to diffuse situations.
• Documents interactions, resolution, or reassignment of issues in the established repository tools and within the established standards and timeframes.

Qualifications

Required

• Bachelor’s degree or an equivalent combination of education and experience in business or a related field.
• Minimum of five years health care/provider servicing experience.
• Demonstrated proficiency in provider servicing, support, and issue resolution.
• Basic knowledge of provider reimbursement and claims payment mechanisms.
• Broad based knowledge of Medicare, Medicaid, and commercial product offerings.
• Proficiency with Microsoft applications and applications specific to HNE.