Provider Support Representative

Summary Under the Provider Network Operations (PNO) Provider Network Management Supervisor's general direction, the PNO Provider Support Representative is responsible for responding to all PNO department queue incoming calls in a courteous and efficient manner, and triaging Client IPA, Provider and Provider office staff telephone inquiries.
Provides first class customer service and ensures that all necessary data is collected/completed properly, accurately, and thoroughly.
The PNO Provider Support Representative provides customer satisfaction to both internal and external personnel and strives to continuously improve service delivery.
Duties and Responsibilities: Records and maintains complete and accurate records of provider communications regarding member service provision according to department documentation requirements Works with provider and provider office staff to resolve, triage, or escalate questions concerning provider completion of delegated and contractual duties Respond appropriately within skill level and documented departmental policies and when appropriate, seeks department leadership advice when responding to complex phone inquiries Follow through in a timely manner on urgent provider requests Provides detailed explanation to client, provider and/or provider office staff regarding IPA and provider status and database setup Informs Supervisor and Department leadership when potential provider problem is communicated by member regarding provider-member relationship or regarding member concern with care rendered Provide exceptional customer service to ensure both Client IPA and contracted provider satisfaction with the IPA Assist in various mandatory projects such as provider outreach, compliance requirements, data cleanup, workflow revisions, upkeep of maintenance and other projects as assigned Foster open lines of communication with Leadership on any network changes or issues Understand and follow the Employee Handbook policies and procedures Ensure HIPAA compliance is always observed/performed Perform other duties/assignments as needed Minimum Job Requirements: High School Diploma or GED required, Bachelor’s degree in healthcare, human services or related field preferred 1+ years Managed Care or Healthcare experience in Network Management, a plus Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) EZ-CAP knowledge, a plus Skills and Abilities Required: Strong communication skills, including both oral and written Ability to maintain multiple priorities and deadlines, with strong follow through Highly motivated with excellent attention to detail Ability to work independently and take direction Ability to quickly learn and use new software tools Demonstrate commitment to the organization’s core values Ability to provide and receive constructive job-related feedback Salary Range: $19-$22 per hour