Provider Inquiry Representative I

3M HEALTHCARE; Portland (ME); On-site; USD 36,000 - 60,000; Full time

Job summary

Martin's Point Health Care is seeking a Provider Service Representative I to professionally respond to telephone inquiries from providers and related entities about benefits, eligibility, plan coverage, enrollment, claims, billing, and payments for the USFHP and Medicare programs.

Your role includes educating providers on policies and procedures, documenting inquiries, and collaborating with other departments to resolve issues, while delivering world-class service and maintaining timely

Qualifications

• Excellent customer service skills.
• Previous experience in a medical billing position preferred.
• Ability to work efficiently and independently.
• Analytical skills in research and problem resolution.
• Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
• Ability to talk and type.
• Active Listener.
• Can work cooperatively with other departments.
• Multi-task oriented with the ability to prioritize.
• Detail oriented.
• Well organized with excellent follow up skills.
• Ability to handle stressful situations and can easily adapt to change.

Responsibilities

• Responds to telephone inquiries from providers and related entities.
• Educates on policies, procedures and self-service options.
• Documents inquiries with accurate information and next steps.
• Collaborates with PI Research and other departments to resolve issues.
• Follows up when first call resolution is not possible.
• Keeps knowledge updated with internal resources.
• Builds trusting relationships with internal and external customers.

Skills

Customer service

Medical billing

Independence

Analytical skills

Active listening

Attention to detail

Multitasking

Time management

Communication

Data entry

Teamwork

Adaptability

Education

High school diploma or equivalent

Job description

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of \"people caring for people,\" Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a \"Great Place to Work\" since 2015.

Position Summary

The Provider Service Representative I’s major responsibility is to professionally respond to telephone inquiries from providers & related entities. The questions will be concerning but not limited to benefits, eligibility, plan coverage, enrollment status, claims adjudication process, billing, and payments for Martin’s Point USFHP Program and Medicare programs.

Key Outcomes

• Answers verbal, written, and electronic inquiries with complete and accurate information and educates when possible regarding Martin’s Point USFHP and Medicare program’s policies, procedures and self-service options.
• Responds to incoming inquiries and partners with provider on possible next steps and or resolution. This should be completed within the timeframes outlined in Representative Expectations document.
• Collaborates with PI Research team and or other departments when needed to resolve Provider issues.
• Follows up in a timely manner with providers when first call resolution is not possible.
• Stays educated on existing and new information available through Provider Services internal resources.
• Documents all provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry.
• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.

Education / Experience

• High school diploma or equivalent.
• 3 years of customer service experience.

Requirements

• Terms of employment may require the applicant/incumbent to qualify, obtain and maintain a Position Level of Trustworthiness from the U.S. Government Office of Personnel Management.
• Additionally, this position may require the applicant/incumbent to be a U.S. citizen.

Skills / Knowledge / Competencies (Behaviors)

• Demonstrates an understanding of and alignment with Martin’s Point Values.
• Excellent customer service skills.
• Previous experience in a medical billing position preferred.
• Ability to work efficiently and independently.
• Analytical skills in research and problem resolution.
• Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
• Ability to talk and type.
• Active Listener.
• Can work cooperatively with other departments.
• Multi-task oriented with the ability to prioritize.
• Detail oriented.
• Well organized with excellent follow up skills.
• Ability to handle stressful situations and can easily adapt to change.
• There are additional competencies linked to individual contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

This position is not eligible for immigration sponsorship.

We are an equal opportunity/affirmative action employer. Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [e-mail].

Do you have a question about careers at Martin’s Point Health Care? Contact us at: [e-mail]