Temporary Provider Service Representative I

Martin's Point Health Care Inc.; Portland (ME); On-site; USD 28,000 - 34,000; Full time

Job summary

Martin's Point Health Care Inc. is seeking a Provider Service Representative I to handle telephone inquiries about benefits, eligibility, and plan coverage for the USFHP and Generations Advantage programs.

In this role you will deliver world-class service, educate callers on policies and self-service options, and collaborate with providers to determine next steps. Strong communication, problem solving, and data entry accuracy are essential.

Qualifications

• High School Diploma or equivalent required.
• 3+ years of customer service experience; medical billing experience preferred.
• Excellent customer service, analytical problem-solving, and strong data entry with high accuracy.
• Strong computer skills and well-organized with excellent follow-up.

Responsibilities

• Answers inquiries about benefits, eligibility, and plan coverage for USFHP and Generations Advantage.
• Educates callers on policies and self-service options.
• Partners with providers on next steps and resolutions.
• Documents inquiries with detailed information per workflows and regulatory requirements.
• Keeps knowledge Updated through Provider Services resources.
• Follows up with providers when first call resolution isn’t possible.

Skills

Customer service

Analytical skills

Data entry

Organized workflow

Education

High school diploma

Tools

Microsoft Office

Data entry systems

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 is responsible for responding to telephone inquiries from providers & related entities regarding benefits, beneficiary eligibility, plan coverage and other related questions received on our benefits and eligibility line. Representatives provide world-class customer service in a professional and timely manner for all inquiries regarding both the Martins Point USFHP and Generations Advantage programs.

PRIMARY DUTIES AND RESPONSIBILITIES

• Answers verbal, written and electronic inquiries with complete and accurate information regarding Martin’s Point USFHP and Medicare programs.
• Provides additional education when applicable to callers related to policies, procedures and existing 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 as 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 inquiries with accurate and detailed information, following all applicable workflows and as well as departmental and regulatory requirements.
• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.
• Performs other duties as assigned.

Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.

POSITION QUALIFICATIONS

• Education High School Diploma or equivalent.
• Experience 3+ years of customer service experience required. Previous experience in a medical billing position preferred.
• Skills Excellent customer service skills Analytical skills in research and problem resolution. Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy). Well-organized with excellent follow-up skills.
• Abilities Demonstrates an understanding of and alignment with Martin’s Point Values. Ability to work efficiently and independently. Ability to talk and type. Active Listener Able to work cooperatively with other departments. Multi-task oriented with the ability to prioritize. Detail oriented. 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.

Pay Range: $20.20 - $24.95 The pay range above reflects the anticipated base pay range based on a full-time position. Actual compensation will be determined based on factors such as experience, skills, qualifications, and other job-related considerations. Employees may also be eligible for additional compensation, including incentive or commission-based programs, where applicable and subject to the terms of the relevant plan.

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]

Martin’s Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin’s Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in Maine, New Hampshire, Vermont, upstate New York, northern and western Pennsylvania, and northeastern and central Ohio). For more information, visit https://careers.martinspoint.org.