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Provider Development/Member Services Support Specialist

4 months ago

Wauwatosa, United States ACCESS HEALTHNET Full time
Job DescriptionJob Description

This dual role is part of both the Provider Development and Member Service teams and reports directly to the Manager of Member Services, with a non-direct reporting relationship to the Provider Development leadership.

The primary role focuses on telephone lead generation for the Provider Development Team and setting meeting appointments for the provider sales representatives.

ESSENTIAL DUTIES

Provider Development

  • Cold call healthcare providers (physicians, facilities, ambulatory surgical centers, imaging facilities, etc) in targeted markets to determine interest; enter all prospects into the CRM
  • Internet research of healthcare providers in targeted markets and specialties; enter all prospects into the CRM
  • Enter and maintain Leads profile data in the CRM
  • Generate reports from the CRM as requested
  • Forward appropriate marketing materials to providers as requested
  • Any other duties/projects as requested/required by Provider Development Team

Member Services

Seek Single Case Agreements from qualified providers for specific requested patient

  • Evaluation of requested services
  • Achieve reasonable understanding of healthcare services and procedures in order to communicate effectively with providers, care navigators and members.
  • Assure completion of SCA paperwork; upload documents into AHN Portal
  • Assist with conversion of SCA providers to full-contract providers
  • As volume dictates, assist Member Services Team
  • Answer phone calls
  • Assist members and care navigators with obtaining services; accurately complete all paperwork and follow process through completion of service.
  • Work within the AHN Portal to upload documents, orders, maintain patient and provider demographics
  • Any other duties/projects as requested/required from Member Services

Requirements

  • Minimum of 1-year experience working for a healthcare provider (physician, hospital, outpatient facility)
  • Licensed or certified medical professional preferred
  • Excellent computer skills with proficiency in Excel
  • High attention to detail
  • Exceptional written and verbal communication skills
  • Ability to work independently and problem solve
  • Ability to effectively and calmly manage patient concerns Ability to prioritize multiple tasks