Provider Relations Representative - Healthcare (Norwalk, CT)

JOB SUMMARY:

The Provider Relations Representative provides continuous, high quality, professional service to members and providers in answering their questions and resolving issues concerning the explanation of health benefits and assistance in accessing care.  Effectively answers and processes inbound/outbound provider calls in a call center/help desk enviornment.

PLEASE NOTE:  This positionn requires prior healthcare experience and is located at our offices in Norwalk, CT.  No relocation assistance is available for this position. 

ESSENTIAL JOB RESPONSIBILITIES:

Primary Responsibilities

• Answers and processes all inbound and outbound provider calls. 
• Provides issue resolution working with internal and external constituents. 
• Listens to requests while accessing, interpreting and explaining system information and makes notations/changes as needed. 
• Focuses on identifying problem and achieving best solution using knowledge of plans, systems, procedures and reference materials.
• Effectively manages conflict and responds to inquiries in a timely manner. 
• Utilizes call tracking to document all calls through to resolution.
• Works independently and in partnership with others to meet and exceed callers’ expectations and requirements.
• Creates and analyzes call tracking reports to identify root cause and recommends process improvements.
• Monitors provider fee requests for medical records for submission to clients.
• Provides administrative support for the audit process and other duties as assigned.

REQUIREMENTS:

• Excellent telephone, written and verbal communications skills.

• Professional demeanor with ability to use appropriate language, tone, style and structure in oral and written communications. 

• Strong organizational skills with focus on attention to details.

• Positive and helpful demeanor in interactions with all internal/external stakeholders.
• Active listening skills.
• Highly skilled at handling multiple tasks simultaneously, prioritizing and meeting deadlines.
• Excellent attendance, punctuality, and strong work ethic.
• Ability to maintain strict confidentiality in all communications involving sensitive member and provider information.
• Works well independently or in a team environment, with ability to work cooperatively and establish cross-functional relationships.
• Exhibits behaviors consistent with iHT Values:

Integrity
Our Clients
Our Team
Accountability
Performance Excellence
Continuous Improvement

MINIMUM QUALIFICATIONS:

• Associates or Bachelors degree (preferred)
• Previous claims examiner and auditing experience strongly preferred. 
• 2+ Years experience within a managed care call center environment (MEMBER / PROVIDER) or provider billing office. 
• Required working knowledge of medical terminology, institutional and professional claims billing, CPT-4 and ICD.9 / .10 codes, and reimbursement methodologies
• Strong computer skills with experience in a Windows environment.

JOB DEMANDS:

• Must be able to sit and use a computer keyboard and work in front of a computer monitor for extended periods of time.
• No travel required.

HOW TO APPLY:

We are currently growing with tremendous opportunities for individuals who want be a part of an extremely fast growing, dynamic and successful company who values and rewards its employees.

To apply for this position, please send your resume along with your cover letter stating your salary history for your two most recent jobs to [Click Here to Email Your Resumé]. 

You may also review and apply for our additional current openings at http://www.ihealthtechnologies.com/careers.html.

Due to the volume of responses we receive, we are unable to reply personally to each submittal.  However, if you are selected to move forward in the process, someone will be in touch with you concerning next steps. 

iHealth Technologies offers a comprehensive benefits package including medical and dental coverage, 401(k) Plan, Profit sharing, vacation, paid holidays

iHealth Technologies supports a diverse workforce and is an Equal Opportunity Employer, M/F/D/V