Provider Support Specialists

4 weeks ago


Northridge, United States Lakeside Medical Full time

We are seeking TEMP Provider Support Specialists/Transition Experts to join our Member Retention Team.

This position will support new Exclusive and Semi-Exclusive Primary Care Physicians (PCPs). The individual will serve as a primary contact for members who choose to retain their PCP by facilitating 3-way telephone calls with the member and member's health plan to transition their IPA/Medical Group. The individual will ensure members continuity of care is transitioned by taking initiative to coordinate with provider offices, Contracting, and/or Utilization Management as needed. The individual will ensure all member service issues and complaints are handled and resolved to achieve member satisfaction and retention. This position will manage prospective member leads generated through advertisements and community events. The individual may be required to attend business and community events in which the individual must network with business partners and prospective members in a professional manner.

* Essential Duties and Responsibilities include the following:
* Support new Exclusive and Semi-Exclusive Primary Care Physicians (PCPs).
* Serve as a primary contact for members who choose to retain their PCP.
* Facilitate 3-way telephone calls with members and health plans.
* Effectively and accurately educate members about PCP and IPA/Medical Group changes.
* Effectively communicate benefits and services available to members.
* Manage a minimum of 30-40 inbound/outbound answered calls per day.
* Assess and coordinate member's continuity of care.
* Coordinate appointments, transportation, and interpreter services.
* Liaise with external business partners and internal departments.
* Coordinate and collaborate on assignments and projects.
* Successfully manage multiple assignments and projects within specified timelines.
* Report assignment and project statuses and results to management.
* Accurately document call results in Microsoft Excel and EZ Cap.
* Serve as a resource for members who require assistance.
* Verify and update member demographic information.
* Own overall satisfaction, retention, and success of Exclusive and Semi-Exclusive PCPs.
* Manage prospective member leads generated via advertisements and events.
* Attend events as needed.
* Duties and responsibilities will increase with experience.

Education and/or Experience:

* High School Diploma or equivalent required. College Degree preferred.
* Reliable transportation and valid California Drivers License and Auto Insurance required.
* Minimum of 4 years of experience at a Health Plan or IPA/Medical Group required.
* Prior experience in customer service, member retention, or network management preferred.
* Strong customer service skills.
* Must have excellent telephone etiquette and effective oral communication skills.
* Excellent interpersonal skills.
* Proficient in Microsoft Office. Must know how to navigate and document in Microsoft Excel.
* Analytical and attention to detail skills.
* Strong time management, organizational, and prioritization skills.
* Ability to manage multiple assignments and projects meeting deadlines.
* Ability to type 45 WPM accurately.
* Ability to work independently with minimal supervision.


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