Provider Enablement Associate

Transcarent; United States; On-site; USD 35,000 - 60,000; Full time

Benefits offered by this job

Competitive benefits package

Paid time off

Job summary

Transcarent is seeking a Provider Enablement Associate to answer inbound calls from provider offices on patient services such as benefits verification, eligibility, and pre-certification. Schedule is Monday–Friday, 10:00am–6:30pm EST in a fast-paced call center.

You will probe to understand provider questions, navigate multiple systems, and resolve issues on first contact while guiding on eligibility and appeals processes.

Qualifications

• High school diploma or GED required.
• 1+ year of customer service or related experience.
• Clear communication and empathy in handling provider calls.

Responsibilities

• Answer high-volume provider calls regarding benefits, eligibility, and pre-certification.
• Probe to understand provider questions and resolve on first call when possible.
• Navigate multiple systems to gather information and assist providers.
• Educate providers on eligibility, coverage, denials, and appeals processes.
• Advise on reducing errors in pre-certification processes and patient support.
• Contribute to policy, system, and procedure improvements as needed.

Skills

Customer service

Verbal & written communication

Empathy

Multi-tasking

Education

High School Diploma/GED

Tools

Web-based applications

Job description

Provider Enablement Ass ociates answer inbound calls from provider offices regarding patient-related services such as verification of benefits, verification of eligibility, pre-certification, and other general physician-patient care support needs.

The work schedule for this position is: Monday - Friday, 10:00am - 6:30pm EST

What you'll do

• Answering calls in a high volume, fast paced call center environment
• Seeking to understand the context behind the provider's call by probing for information to understand the provider's questions or support needs in order to ensure first call resolution
• Navigating and engaging multiple systems, and pulling the puzzle pieces together to resolve provider questions, complex issues and requests
• Offering guidance to providers regarding their patient's eligibility, coverage, pre-certification denials and appeals processes
• Educating providers on how to reduce errors in pre-certification process due to lack of information, and educating them on how to most effectively support their patients in the appeals process
• Navigating and providing input to policies, systems, methods, and procedures for the effective management of key business processes
• Performing other relevant tasks, as needed

What w e’re l ooking f or

• High School Diploma/GED required
• 1+ years employment experience in the customer service industry, the service industry, administration, or reception
• 1+ years hands on experience with web-based applications
• Excellent customer service skills; strong verbal and written communication
• Ability to respond empathically
• Experience resolving benefits and provider network questions in a fast paced , call center environment
• Ability to answer the unasked questions providing first call resolution
• Ability to navigate multiple systems and multi-task
• Ability to de-escalate tense situations and turn them into productive, resolve-oriented conversations
• Ability to navigate basic math scenarios including percentages, premiums/payments and out of pocket expenses (deductibles/coinsurance/copays)

Who We Are

Transcarent is the One Place for Health and Care, bringing medical, pharmacy, and point solutions together with the WayFinding experience, the first and only generative AI-powered health and care platform for health consumers.

Our WayFinding experience, paired with transparent and consumer-driven pharmacy care, 2nd.MD expert medical opinions, and virtual primary care, works seamlessly with comprehensive Care Experiences - Cancer Care, Surgery Care, and Weight Health - to support people with all of their health needs, simple or serious. More than 1,700 employers and health plans rely on us to provide information, guidance, and care, empowering health consumers with more choice, an experience they love, access to higher-quality care, and lower costs for 21 million Members. For more information, visit transcarent.com , and follow us on LinkedIn .

At Transcarent, Our Values Guide Everything We Do

• People First: We prioritize our Members, clients, and each other in every decision
• Care: Every decision starts with improving health and care for our Members
• Resilience: We push boundaries and take the uncharted path to change an industry
• Results: We take ownership, solve with speed, and deliver for our people and each other
• Humble and Human: We lead with humility, bring fun to tough moments, and go further together

Total Rewards

Individual compensation packages are based on a few different factors unique to each candidate, including primary work location and an evaluation of a candidate's skills, experience, market demands, and internal equity. Salary is just one component of Transcarent's total package. All regular employees are also eligible for the corporate bonus program or a sales incentive (target included in OTE) as well as stock options.

Our benefits and perks programs include, but are not limited to:

• Competitive medical, dental, and vision coverage
• Competitive 401(k) Plan with a generous company match
• Flexible Time Off/Paid Time Off, 13 paid holidays
• Protection Plans including Life Insurance, Disability Insurance, and Supplemental Insurance
• Mental Health and Wellness benefits

Transcarent is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reach out!

Research shows that candidates from underrepresented backgrounds often don't apply unless they meet 100% of the job criteria. While we have worked to consolidate the minimum qualifications for each role, we aren't looking for someone who checks each box on a page; we're looking for active learners and people who care about disrupting the current health and care with their unique experiences.