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Martin’s Point Health Care in Portland, ME is seeking a Provider Service Representative I to professionally respond to provider inquiries about benefits, enrollment, claims, and billing for USFHP and Medicare programs. You will educate callers, document interactions, and coordinate with internal teams to resolve issues, delivering high-quality service.
Requirements include a high school diploma or equivalent and 3 years of customer service experience. U.S.
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 amission 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.
The Provider Service Representative I’s major responsibility is to professionally respond to telephone inquiries from providers & related entities. The questions will be concerning but not limited to benefits, eligibility, plan coverage, enrollment status, claims adjudication process, billing, and payments for Martin’s Point USFHP Program and Medicare programs.
Job Description
Answers verbal, written and electronic inquiries with complete and accurate information and educates when possible regarding Martin’s Point USFHP and Medicare program’s policies, procedures and 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 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 provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry.
Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.
Requirements:
Terms of employment may require the applicant/incumbent to qualify, obtain and maintain a Position Level of Trustworthiness from the U.S. Government Office of Personnel Management. Additionally, this position may require the applicant/incumbent to be a U.S. citizen.
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 - $24.95The 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.
Do you have a question about careers at Martin’s Point Health Care? Contact us at:jobinquiries@martinspoint.org