Relationship Associate

Prime Health Services; Franklin (TN); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Disability Insurance

Life Insurance

PTO

Employee events

Job summary

Prime Health Services is seeking a Relationship Associate to deliver high-quality customer service to Providers and Clients, answer questions, resolve issues, locate in-network providers, and support contract negotiations.

You will generate client-centric reports, verify provider billing, participate in meetings, and assist members with locating in-network options. A degree in Business or related field and 1+ year of healthcare customer service are preferred.

Qualifications

• Associate’s or Bachelor’s Degree in Business Administration or related field.
• 1+ years of customer service experience, preferably in healthcare.

Responsibilities

• Manage and maintain all inquiries within Ticket System and accurate records of all customer interactions
• Respond to all Client requests via phone or email in a timely manner
• Answer incoming calls to the Account Management/Client Services (Customer Relations) Que promptly
• Populate a variety of Client-specific reports including complex PPO repricing logic, demographic requests, and interpreting /analyzing / remaining current on utilization/industry data/trends
• Input Provider Nominations and communicate with respective internal departments as needed
• Verify Provider billing information and demographics
• Participate in Client meetings as needed (MS Teams, on/off site – travel may be required)
• Assist members and injured workers with locating In-network Provider options

Skills

Customer service

Communication

Microsoft Office

MS Teams

Data analysis

Education

Associate’s or Bachelor’s Degree in Business Administration

Tools

MS Teams

Microsoft Word

Microsoft Excel

Outlook

Job description

Description

A Relationship Associate is responsible for providing high-quality customer service to Providers and Clients to include answering questions, resolving issues, locating in-network providers, nominating out-of-network providers, generating Client centric reports, contract negotiations, and providing information/education about Prime Health Services product and service offerings.

What You'll Do

• Manage and maintain all inquiries within Ticket System and accurate records of all customer interactions
• Respond to all Client requests via phone or email in a timely manner
• Answer incoming calls to the Account Management/Client Services (Customer Relations) Que promptly
• Populate a variety of Client-specific reports including complex PPO repricing logic, demographic requests, and interpreting /analyzing / remaining current on utilization/industry data/trends
• Input Provider Nominations and communicate with respective internal departments as needed
• Verify Provider billing information and demographics
• Participate in Client meetings as needed (MS Teams, on/off site – travel may be required)
• Assist members and injured workers with locating In-network Provider options

Requirements

What We're Looking For

• Associate’s or Bachelor’s Degree in Business Administration or related field of study from an accredited college or university is required; direct work experience may be substituted for up to 50% of the education requirement
• 1+ years of customer service experience, preferably in the healthcare industry

Competencies

• Exceptional organization and time management skills – ability to handle a high volume of accounts, multi task, and adapt as business needs demand
• Ability to work effectively/collaboratively in a fast paced, deadline driven, and changing environment
• Strong critical thinking, problem solving (attention to detail), and investigative skills
• Friendly, calm, and professional demeanor (customer focused), results driven, and collaborative
• Strong work ethic and the ability to maintain confidential information as required
• Excellent communication skills (verbal and written)
• Proficient in Microsoft Office Suite, including Word, Excel, Outlook, and MS Teams

Why You’ll Love Working at Prime Health Services

• Medical Insurance (high deductible plan with an HSA)
• Dental Insurance
• Vision Insurance
• Short-term and long-term disability paid by the company
• Group term life paid by the company
• Generous PTO Policy
• Employee recognition programs with monetary rewards
• Corporate office amenities
• Regular employee events

About Us

Prime Health Services (PHS) is a national medical cost containment company with a noteworthy PPO Network used by insurance carriers, TPA’s, self-insureds, and governmental entities. Our tech-focused nature allows clients to take advantage of the flexibility of customization while not compromising on bill processing speed. Since 2001, we have specialized in medical provider network development and offer clients a tailored approach to medical cost containment: quality health care at discounted rates.