Provider Service Representative I

WeShare Health; Santa Ana (CA); On-site; USD 22,041 - 33,062; Full time

Benefits offered by this job

Competitive Hourly

Health, Dental, Vision, & 403(b)

Job summary

UHSM is seeking a Provider Service Representative to build strong relationships with healthcare providers and ensure accurate medical billings and inquiries. This entry-level role supports provider communications, billing resolution, data entry, and member assistance.

The position is based in the United States with opportunities to grow within a mission-driven nonprofit. Responsibilities include managing a high volume of calls, emails, and chats, coordinating with internal teams on provider

Qualifications

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

Responsibilities

• Provider Relationship Management: manage high volume calls, emails, and chats to assist providers and resolve inquiries.
• Medical Billing Processing And Resolution: review and process billing submissions, resolve discrepancies, denials, and appeals.
• Data Entry And Documentation: enter provider data and billing information accurately; maintain organized documentation.
• Customer Service And Support: assist members and providers with inquiries related to benefits and billing and provide courteous support.

Skills

Customer service

Communication

Interpersonal skills

Multitasking

Education

High school diploma or equivalent

Tools

Microsoft Office Suite

Job description

Unite Health Share Ministries (UHSM) is a nonprofit, faith-based health sharing ministry that facilitates member-to-member health sharing among fellow Christians, serving as a connector to administer medical cost sharing. The UHSM mission is to help Christian families fulfill their God-given purpose to care for one another and to positively impact our communities. Headquartered in Norfolk, VA, UHSM takes a modern approach to health sharing that prioritizes holistic health and wellbeing. UHSM offers simple, fair, and friendly health share programs to its members.

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

UHSM 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.