Provider Service Representative I

WeShare Health; Orange (CA); Sur place; USD 22 000 - 30 000; Plein temps

Avantages offerts par ce poste

Competitive hourly

Health benefits

Résumé du poste

WeShare Health in California is seeking a Provider Service Representative to build strong relationships with healthcare providers and facilitate communication around billing and network matters.

The role focuses on processing medical billings, resolving discrepancies, and ensuring accurate data entry and documentation to support high-quality care for members.

Qualifications

• High school diploma or equivalent.
• 6+ months of experience in a customer service role, working with high volume of calls.
• Bachelor's degree preferred.
• Strong communication and interpersonal skills.
• Detail-oriented and highly organized, with a focus on accuracy and efficiency in data entry and documentation.
• Ability to multitask and prioritize tasks in a fast-paced environment.
• Proficiency in Microsoft Office Suite and experience with database systems (healthcare software a plus).

Responsabilités

• Provider Relationship Management: Manage high volume of inbound/outbound calls, emails, and chats to assist providers with inquiries and requests, ensuring timely and accurate resolution.
• Communicate UHSM's policies, procedures, and requirements to providers clearly and professionally.
• Collaborate with internal teams to coordinate provider contracting, credentialing, and network management activities.

Connaissances

Customer service

Communication

Interpersonal skills

Data entry

Formation

High school diploma or equivalent

Bachelor's degree

Outils

Microsoft Office Suite

Database systems

Description du poste

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option. WeShare Health is that option. WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point. Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit. WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work by our employees. If you have a bias for action, enjoy challenges, and want to challenge the status quo to make an impact in a massive industry, WeShare Health might be the place for you!

About This Role

The Provider Service Representative at UHSM plays a vital role in building and maintaining positive relationships with healthcare providers, facilitating communication, and ensuring accurate and timely processing of medical billings and inquiries. This entry-level position offers an excellent opportunity for individuals seeking to launch their career in the healthcare industry and make a meaningful impact on the lives of others.

Key Responsibilities

Provider Relationship Management:

• Manage high volume of inbound/outbound calls, emails, and chats to assist with healthcare professionals with inquires and requests, ensuring timely and accurate resolution.
• Communicate UHSM's policies, procedures, and requirements to providers in a clear and professional manner.
• Collaborate with internal teams to coordinate provider contracting, credentialing, and network management activities.

Medical Billing Processing And Resolution

• Review and process provider medical billing submissions accurately and efficiently, ensuring adherence to regulatory guidelines and company policies.
• Investigate and resolve medical billing discrepancies, denials, and appeals in a timely manner, working closely with internal stakeholders and providers to achieve resolution.

Data Entry And Documentation

• Accurately enter provider data, medical billing information, and other relevant details into the company's database systems.
• Maintain thorough and organized documentation of provider interactions, claim resolutions, and other pertinent information.

Customer Service And Support

• Assist members and providers with inquiries related to benefits, coverage, medical billing status, and other healthcare-related matters.
• Provide exceptional customer service by addressing inquiries promptly, professionally, and courteously.

Required Qualifications

• High school diploma or equivalent.
• 6+ months of experience in a customer service role, working with high volume of calls.

Preferred Qualifications

• Bachelor's degree.
• Strong communication and interpersonal skills, with the ability to effectively interact with healthcare providers and internal teams.
• Detail-oriented and highly organized, with a focus on accuracy and efficiency in data entry and documentation.
• Customer service mindset, with a commitment to delivering excellent service to providers and members.
• Ability to multitask and prioritize tasks in a fast-paced environment.
• Proficiency in Microsoft Office Suite and experience with database systems (experience with healthcare-specific software a plus).

What We Offer

• Competitive Hourly
• Health, Dental, Vision, & 403(b)
• Ability to make important enhancements to the Healthcare industry
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere

WeShare Health is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.