Introduction to American Specialty Health Incorporated
American Specialty Health Incorporated is a leading provider of specialty health services, dedicated to delivering exceptional support to healthcare practitioners and patients alike. Our mission is to improve the quality of life for individuals by providing innovative solutions and unparalleled customer service. We are now seeking an exceptional Provider Relations Representative I to join our team, working remotely and playing a vital role in our Provider Relations department.
About the Role
As a Provider Relations Representative I, you will be the primary point of contact for healthcare practitioners, responding to inquiries, resolving issues, and delivering high-quality customer service via our telephone queue system. Your expertise will focus on credentialing, re-credentialing, and contracting, ensuring efficient and effective resolution of practitioner inquiries or complaints. If you are a motivated and customer-focused individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.
Key Responsibilities
- Answers incoming calls in a professional, accurate, timely, and courteous manner from the Provider Relations and Credentialing queue.
- Assists practitioners, staff, and clients with questions regarding credentialing, re-credentialing, participation requirements, contractual issues, and high-level administrative problems.
- Performs credentialing and re-credentialing activities according to plan specifications.
- Forwards complex requests that require research to the appropriate ASHCore bucket or PRL supervisor to achieve appropriate resolution.
- Captures practitioner complaints and resolves or forwards to the appropriate ASHCore bucket or PRL supervisor for resolution.
- Captures practitioner change information, documents, and forwards as required to record changes in appropriate databases.
- Handles necessary administrative duties to properly support, document, and resolve practitioner inquiries.
- Maintains confidentiality of practitioner files, participation data, practitioner records/documents, and all discussions relative to recruiting, contracting, and credentialing processes.
- Attends department and all-staff meetings to increase knowledge and foster teamwork.
- Pull CAQH applications when providers call in with CAQH number and drop application in designated folder.
- Download CAQH applications for PTOT practitioners that are being added to a provider.
Essential Qualifications
To be successful in this role, you will need:
- An Associate's degree or equivalent preferred, although a High School diploma is required.
- Minimum two years of progressive experience performing customer service duties preferred.
- Specialty healthcare or healthcare experience preferred.
- Credentialing and re-credentialing experience preferred.
- Proficiency in MS Office with experience in word processing and spreadsheet applications.
- A general understanding of Provider Relations Guidelines.
Preferred Qualifications
While not essential, the following qualifications are highly desirable:
- Previous experience in a call center or customer service environment.
- Knowledge of healthcare regulations and compliance.
- Experience with database management and record-keeping.
- Strong analytical and problem-solving skills.
Core Competencies
To excel in this role, you will need to demonstrate:
- The ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Excellent customer service skills to meet the needs and expectations of both internal and external customers.
- Strong listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- The ability to effectively organize, prioritize, multi-task, and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- The ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
- The ability to exercise strict confidentiality in all matters.
Skills and Competencies
In addition to the essential and preferred qualifications, you will need to possess:
- Strong communication and interpersonal skills.
- Ability to work in a fast-paced environment with multiple priorities.
- Proficiency in Microsoft Office, including Word, Excel, and Outlook.
- Ability to learn and adapt to new systems and processes.
- Strong problem-solving and analytical skills.
Career Growth Opportunities and Learning Benefits
At American Specialty Health Incorporated, we are committed to the growth and development of our employees. As a Provider Relations Representative I, you will have access to:
- Comprehensive training programs to enhance your skills and knowledge.
- Ongoing coaching and feedback to support your career development.
- Opportunities for advancement within the company.
- A dynamic and supportive work environment that encourages collaboration and innovation.
Work Environment and Company Culture
Our company culture is built on a foundation of respect, integrity, and excellence. We value our employees and strive to create a work environment that is:
- Supportive and inclusive.
- Dynamic and innovative.
- Focused on delivering exceptional customer service.
- Committed to the growth and development of our employees.
Compensation, Perks, and Benefits
We offer a competitive salary of $15.00 per hour, as well as a range of benefits, including:
- Comprehensive health insurance.
- 401(k) retirement plan.
- Paid time off and holidays.
- Opportunities for professional growth and development.
Conclusion
If you are a motivated and customer-focused individual with a passion for healthcare, we encourage you to apply for this exciting opportunity. As a Provider Relations Representative I, you will play a vital role in our Provider Relations department, delivering exceptional support to healthcare practitioners and patients alike. Don't miss out on this chance to join our dynamic team and take your career to the next level. Apply now and discover a rewarding and challenging career with American Specialty Health Incorporated.
How to Apply
To apply for this role, please click on the link below. We look forward to receiving your application and discussing this opportunity further.
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