ACCESS Provider Services Specialist

Emploi pas sur LinkedIn

🕒 il y a 24 jours

🌲 North Carolina – Distant

🌲 North Carolina – Remote

💵 $42 000 - $65 000 / an

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

👻 Score fantôme 1%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Vaya Health

Site WebLinkedInTous les Emplois

501 - 1000 employés

Fondée en 1972

🛡️ Assurance

💼 Conseil

📦 Logistique

Insurance • Consulting • Logistics

Vaya Health est une organisation basée en Caroline du Nord qui gère les services pour les individus ayant des problèmes de santé comportementale, y compris les troubles mentaux et de l'usage de substances, les déficiences intellectuelles et développementales (D/I), et les traumatismes crâniens. L'organisation fournit des services Medicaid adaptés pour ces populations, en se concentrant sur une approche centrée sur la personne qui connecte les membres aux soins et soutiens nécessaires pour leurs objectifs uniques en matière de santé et bien-être. Vaya Health met l'accent sur la collaboration entre divers domaines de soins pour garantir un soutien complet à ses membres, favorisant des communautés plus saines dans toute la région.

Description

• Assist network providers with inquiries related to claims, contracts, authorizations, benefits, services, registries, and community resources • Screen, handle, and route incoming phone calls, aiming for first-call resolution • Initiate outbound calls based on established work queues, lists, and assignments • Document all calls and routing activities through defined workflows and processes • Provide information and respond to providers’ inquiries, concerns, and questions by phone • Perform initial triage of callers’ needs and determine appropriate call handling • Educate providers about resources available through Provider Central • Provide navigation support for forms, training guides, and contracting information • Authenticate providers, identify needs, and connect callers to the appropriate One Touch workgroup • Serve as liaison between departments regarding questions, processes, and information resources • Update materials related to call center operations when assigned • Serve as a subject matter expert for Provider Support Line call center operations • Complete progress notes, forms, reports, and other required documentation at the time of the call and by the end of the workday or shift • Assist with specialized ACCESS Call Center departmental projects and reviews as requested by management • Perform other duties as assigned

🎯 Exigences

• Bachelor’s degree in a Human Services field and at least two years of experience working with adults or children with serious psychiatric, chemical dependence, or developmental disability in a community mental health center or similar setting; OR bachelor’s degree from an accredited college or university and at least four years of comparable experience • Must be qualified as a Qualified Professional according to 10A NCAC 27G .0104 • Must reside in North Carolina or within 40 miles of the North Carolina border • Considerable knowledge of the MH/SU/DD service array provided through the network of Vaya Partners providers • Knowledge of Medicaid 1115, Medicaid B and C waivers, and Vaya Partners accreditation requirements • Understanding of BH I/DD Tailored Plan eligibility, services, policies, procedures, and Provider Manual requirements • Ability to handle confidential healthcare information and protected health information (PHI), comply with HIPAA and related confidentiality laws, complete required confidentiality training, and sign a confidentiality statement • High level of diplomacy and discretion • Exceptional interpersonal and communication skills • Prompt independent decision-making, problem solving, negotiation, arbitration, and conflict resolution skills • Ability to organize multiple tasks and priorities and manage projects from start to finish • Ability to adapt to changing priorities • Close visual acuity and ability to perform sedentary work, sit for extended periods, and lift up to 10 pounds • Preferred: 2+ years of experience in a network management-related role handling complex network providers in the health care industry

🏖️ Avantages

• Monday–Friday work schedule, 9:30 am–6:00 pm • 40-hour work week • Overtime compensation eligibility • Remote, home-based virtual position • Holiday rotation as required by the business