Healthcare Service Representative
5 days ago
The estimated salary for this position is $40,000 - $55,000 per year. As a Patient Access Representative, you will be responsible for ensuring the accuracy and completeness of provider data by performing essential data entry, validation, and communication tasks.
This role supports the Provider Services Team by addressing provider inquiries and maintaining efficient workflows in compliance with established procedures.
Key Responsibilities:
- Enter provider data into Salesforce Pre-enrollment Portal and V12 system accurately and efficiently.
- Monitor and review the V12 dashboard to identify and follow up on error records.
- Perform manual validation of provider information against the ODM PNM system.
- Communicate with providers via email to update data in the PNM system or complete Provider Information Update Forms.
- Act as a liaison between providers, medical groups, and the health plan to resolve inquiries related to claims, eligibility, and other issues.
- Assist providers with dismissing or reassigning members incorrectly attributed to them.
- Educate providers on regulations, procedures, and access to resources.
- Support Provider Services Team members during field activities.
- Document requests and actions in accordance with departmental procedures.
- Assist with training new Provider Services staff members as needed.
- Attend off-site meetings with medical groups and providers when necessary.
- Adhere to workplace safety standards and organizational policies.
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