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Provider Relations Representative

Company: UHSM
Location: Santa Ana
Posted on: November 26, 2022

Job Description:

The Concierge Team serves providers to facilitate the delivery of healthcare acting as an ambassador on behalf of the member. In a contact center work-environment, the Concierge Team deploys empathy, problem-solving skills, and perseverance to exceed the expectations of its members and providers. The Concierge Team will respond to all member and provider inquiries delivering top caliber service through multiple communication channels. With the assistance of data and technology, we guide providers through scheduling, benefits, medical bills, Pre Auth status, and care services to ensure a high value experience.

*Key Responsibilities*
* Respond to the inbound provider communications (call, text, email, chat) while adhering to designated protocols and service responses while providing exceptional customer service
* Assist in cases requiring additional non-clinical follow-up and care coordination, including, but not limited to eligibility, scheduling appointments, program benefits, medical bills, provider network inquiries, Pre authorizations, and care management program assistance
* Communicate and collaborate with interdisciplinary teams, when needed ensure effective soft transfers with utilization management and clinical teams
* Accurately collects and documents the appropriate level of information to facilitate resolution and identify trends
* Function as a detective to find creative solutions to difficult problems
* Ensure problem resolution or smoothly transition to a higher-level advocate or manager when appropriate
* Participate in process improvement activities by openly sharing thoughts, ideas, and constructive feedback to technical, and management
* Recognizes the presence of provider issues that may require immediate clinical assessment or action, notifies clinical staff, and follow up/updates provider weekly until resolved
* Closely monitors all open cases, updating provider and/or member on a weekly basis until issue is revolved
* Proactively making outbound calls to providers educating who we are, how we work, and why they should work with us -persuade participation-
* May send reimbursement and appeal forms and walk them thru that process
* Responds appropriately to inquiries and complaints.
* Can troubleshoot and problem solve independently as situations occur
* Ensures adherence to daily operating metrics systems
* Other duties and projects as assigned

* 3 years of customer service experience in the healthcare setting
* Passionate, excited, and carry a positive attitude; a strong desire to simplify healthcare
* Experience in providing excellent customer service and have a heighten the empathetic ability
* Skills to multi-task and manage competing priorities can triage appropriately and can apply critical thinking to solve problems
* Tech savvy and possess a capability to quickly learn new applications
* Ability to maintain composure and compassion while addressing a high volume of competing tasks
* Comfortable with ambiguity and open to collaborative environments
* Strong moral compass and commitment to company values
* Motivated to learn, continually improve, and operate to one's fullest potential
* Bilingual skills (preferred)
* Strong organizational skills
* Able to work in a fast-paced environment
* Strong desire to help others
* Excellent follow up and time management skills
* Excellent listening and communication skills
* Excellent writing skills
* High School Diploma or equivalent
* Able to work overtime evenings, weekends and holidays as needed based on the needs of the business

*What we offer*
* Competitive Salary with Team + Health, Dental, Vision, 403(b) and Total Rewards
* Ability to make important enhancements to the Healthcare industry
* Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere

*About UHSM*

Unite Health Share Ministries (UHSM) is a nonprofit, faith-based health sharing ministry that facilitates member-to-member health sharing among fellow Christians, serving as a connector to administer medical cost sharing. The UHSM mission is to help Christian families fulfill their God-given purpose to care for one another and to positively impact our communities. Headquartered in Norfolk, VA, UHSM takes a modern approach to health sharing that prioritizes holistic health and wellbeing. UHSM offers simple, fair, and friendly health share programs to its members.

Job Type: Full-time

Pay: $21.00 per hour

* 401(k)
* Dental insurance
* Health insurance
* Paid time off
* Vision insurance
* 8 hour shift
* Day shift

Ability to commute/relocate:
* Santa Ana, CA 92707: Reliably commute or planning to relocate before starting work (Required)

* High school or equivalent (Required)

* Call center: 1 year (Required)
* Customer service: 1 year (Required)

Work Location: Hybrid remote in Santa Ana, CA 92707%58047475%

Keywords: UHSM, Santa Ana , Provider Relations Representative, Other , Santa Ana, California

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