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Primary Responsibilities: Assess and resolve specific provider concerns, developing and implementing solutions that are beneficial to providers, LHI Customers and LHI Educate providers on fee structures to ensure collaborative agreement and understanding of LHI Services and the fees associated with them Staff Provider Relations Telephone Queue, adequately respond to and resolve incoming calls in the appropriate manner Respond to Customer Satisfaction Surveys and Customer Complaints within the required time frame through investigation and problem solving that results in positive outcomes Provide explanations and information to others on topics within area of expertise Proactively review and maintain provider compliance documents to ensure active status within provider network Collaborate with other departments to assign qualified providers to orders within the contractually allowed mileage radius of the patient's home zip code Assist in complex end-to-end provider claims processing and resolution, including but not limited to, claims reprocessing, modifying orders, and adhering to contractual guidelines within claim requirements Ability to resolve complex complaints within strict deadlines while ensuring accuracy and contractual compliance Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist in identifying gaps in network composition and services to support network contracting and adequacy teams Utilize relevant data and facts to analyze and resolve a variety of issues within area of expertise Investigate and identify solutions to non-standard requests and problems, with some assistance from others Manage and prioritize work effectively to meet deadlines, ensuring timely responses to leadership, providers, and assigned tasks Provide explanations and information to others on topics within area of expertise Use pertinent data and facts to identify and solve a range of problems within area of expertise Educate providers on a wide range of topics to enhance their knowledge and compliance with policies, procedures, and best practices Acts as a resource for others with less experience and promotes positive work environment Coordinate meetings with providers to discuss a variety of topics, including JOC meetings Attend and contribute to multi-department meetings Ability to travel as needed Perform other duties as assigned Required Qualifications: High School Diploma/GED 1+ years of experience in provider relations 1+ years of computer proficiency experience with Microsoft Office (Word, Excel, and Outlook) and be able to access multiple web applications Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Ability to work an 8-hour shift between 8:00 am - 6:00 pm Monday through Friday based upon business needs Access to reliable transportation and a current and non-restricted state driver’s license and state-required insurance with the ability to travel 10% of the time within 100 miles of territory assigned Preferred Qualifications: Knowledge of rates and managing subcontractor relationships Knowledge of MedNet Ability to effectively manage provider accounts resulting in provider retention Ability to develop strong professional relationships while demonstrating a clear understanding of complex business structures Knowledge of medical terminology Soft Skills: Ability to work independently and maintain good judgment and accountability Demonstrated ability to work well with health care providers Strong organizational and time management skills Ability to multi-task and prioritize tasks to meet all deadlines Ability to work well under pressure in a fast-paced environment Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
Compensation $24 – $43 / hour Listed by Logistics Health Incorporated (LHI) Apply now Share this job