Provider Experience Center Representative

Job not on LinkedIn

🔥 7 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $20 - $30 / hour

⏱ Part Time

🟡 Mid-level

🟠 Senior

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👻 Ghost score 0%

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Banner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Banner Health is a leading healthcare system committed to making healthcare easier through comprehensive patient services and resources. They provide a safe place for care with services ranging from emergency and urgent care, imaging, and surgery centers to maternity and hospice care. Banner Health also offers telehealth options to ensure access to healthcare, regardless of location. They support athletes through Banner Orthopedics & Sports Medicine and have been recognized for exceptional patient care. With advanced digital tools, they aim to manage healthcare seamlessly for their patients.

📋 Description

• Answer inbound calls from providers and their staff • Research, document, and respond to provider inquiries and escalated calls • Handle high-volume inbound and outbound health insurance provider-related calls • Provide accurate information regarding claims, benefits, member out-of-pocket expenses, and payments by telephone or in writing • Verify and adjudicate claim payments according to plan guidelines • Analyze issues and conduct appropriate follow-up with physicians, facility staff, professional staff, and physician office staff • Identify and resolve managed care issues involving claims, contract interpretation, utilization management, eligibility, and general operations • Interpret contract language and resolve contract issues • Assist internal departments with provider appeals • Educate physicians, office staff, hospitals, and insurance plan administration staff • Work on assigned special projects • Meet department quality, quantity, timeliness, and compliance standards • Determine work priorities and complete tasks with minimal supervision

🎯 Requirements

• High school diploma/GED or equivalent working knowledge • Three to four years of substantial previous related work experience in healthcare services, with experience in a high-volume service center or managed care environment • Ability to multitask between inbound calls, database or resource-tool searches, and professional customer service • Excellent verbal and written communication skills • Ability to meet deadlines in a multifunctional task environment • Excellent organizational skills • Operational knowledge of word processing, spreadsheets, data entry, fax machines, and other computer-related skills • Ability to acquire and use the company’s provider information systems • Fundamental knowledge of organizational expectations • Ability to establish daily work priorities and work efficiently • Preferred: associate’s degree or equivalent business/healthcare knowledge • Preferred: one to two years of experience in medical claims adjudication, contract interpretation, billing and coding, and medical terminology • Additional related education and/or experience preferred • Must reside in the state of Arizona

🏖️ Benefits

• Remote work arrangement • Please note Banner Staffing Services roles do not offer medical benefits or paid time off accrual • Assignment-based role with no guarantee of hours