Provider Relations Representative

Valenz; Phoenix (AZ); Remote; USD 40,000 - 60,000; Full time

Job summary

A leading healthcare organization is seeking a Provider Relations Representative to educate providers and members about plan designs, address reimbursement inquiries, and foster long-term relationships. This fully remote role requires strong communication skills and over a year of customer service experience. Join a winning team committed to innovating the healthcare experience.

Benefits

Generously subsidized Medical, Dental, and Vision insurance

401K with company match

Flexible working environment

Generous Paid Time Off

Employee Assistance Program

Paid maternity and paternity leave

Pet insurance

Qualifications

• 1+ years of experience in customer service.
• Excellent verbal and written communication skills.
• Ability to work in a fast-paced, customer focused environment.

Responsibilities

• Facilitate inquiries from providers regarding reimbursement rates.
• Negotiate ongoing and single case agreements.
• Direct members to in-network or RBP accepting providers.
• Develop trust with members and providers.

Skills

Customer service experience

Verbal communication skills

Written communication skills

Ability to work independently

Fast-paced environment adaptability

Job description

Vālenz Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.

About Our Opportunity

As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—or customer love as we say!

Responsibilities

• Facilitate inquiries from providers regarding reimbursement rates.
• Negotiate ongoing and single case agreements (SCAs).
• Direct members to in-network or RBP accepting providers.
• Focus on the member journey and minimizing disruption to providers.
• Develop trust with members and providers to ensure long-term relationships.
• Anticipate and identify issues and escalate to the appropriate manager or team leader.
• Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn-around-times, and success rates.
• Facilitate the appeals process.
• Maintain compliance with company policies and procedures.
• Performs related duties as assigned by supervisor.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team

• 1+ years of experience in customer service.
• Experience working independently and completing assignments within given instructions, routines, and accepted practices.
• Excellent verbal and written communication skills.
• Ability to work in a fast-paced, customer focused, and deadline-driven environment.

A plus if you have

• Experience working in healthcare environment with providers.

Where You’ll Work

This is a fully remote position, and we’ll provide all the necessary equipment!

• Work Environment: You’ll need a quiet workspace that is free from distractions.
• Technology: Reliable internet connection—if you can use streaming services, you’re good to go!
• Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
• Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

Why You\'ll Love Working Here

Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.

Benefits

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

Note: This statement has been retained for compliance purposes in its original form; the text has been reformatted to meet the required HTML structure. Valenz is committed to equal employment opportunity for all associates and to providing a work environment free of discrimination and harassment. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to protected characteristics.