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Provider Service Representative

3 months ago

Flint, United States A-Line Staffing Solutions Full time
Job DescriptionJob Description

Full time Hybrid Provider Service Representative openings in Flint, MI with a major healthcare company Starting ASAP Apply now to Chris Meyer with A-Line

Hybrid Provider Service Representative PAY RATE: $17.00 per hour

Hybrid Provider Service Representative HOURS: Monday – Friday from 8:30am – 5:00pm

Hybrid Provider Service Representative Job Responsibilities:

·       Ensures members awareness of and access to primary care services through education and coordination of members and providers resulting in HEDIS improvement.

·       Engages with assigned Provider offices on HEDIS gaps in care, work collaboratively with the provider office to review records, close gaps in care in supplemental databases, and schedule patient appointments upon request.

·       Performs annual HEDIS Hybrid audit activities, including scheduling appointments with the office, reviewing records through provider office EMR or onsite as required.

·       Participates in the development and delivery of Outreach Programs, including call programs and member contacts which result in key HEDIS measures attainment.

·       Establishes and maintains relationships with the primary care network, community programs, providers and members.

·       Coordinates quality improvement initiatives with Medical Management Dept., i.e., Preventative Health Screenings.

·       Communicates updated active community resource information to medical management and individual members as needed

Hybrid Provider Service Representative Requirements:

  • 2+ years of Experience in a healthcare customer service related role
  • Must have valid state drivers license, reliable transportation, and auto insurance
  • Proficiency with Microsoft Excel.
  • Must have knowledge of medical terminology
  • High school diploma or GED

Why Apply:

  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • GREAT Hours
  • Competitive Pay Rate

If you think this Hybrid Provider Service Representative position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting

 

Healthcare, call center, mail order medications, Insurance Verification, Medicare, Medicaid, Medical billing, EOB, Benefit, Patient Service, PBM, Enrollment, Provider Services, Pharmacy, prior authorization, reimbursement counselor, Medical customer service, inbound calls, outbound calls, answer phones, make calls, medical terminology, medical office, medical claims, healthcare claims, claims processing