Senior Provider Relations Representative - Remote reputed company WA, MO, or NC

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together. This is an opportunity that's reputed company about where you've been. Your experience. Your potential. Your skills. reputed company solid up to now. It's also an opportunity to learn what's reputed company. Because on the team at reputed company, your potential and your impact can be career changing. We're driving reputed company higher levels of sophistication in how provider networks are formed and operated. The goal is to improve the quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service and consultative skills to meet with network providers and help enhance their experience and performance. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader. If you are located in WA, MO, or NC, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:

• Facilitate end-to-end provider issues and resolution
• Use pertinent data and facts to identify and solve a range of problems
• Investigate non-standard requests and problems
• Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
• Help implement training and development of external providers through education programs
• Identify gaps in network composition and services to assist network contracting and development teams
• Responsible for reputed company reputed company aspects of issue resolution
• Claims systems utilization, claims-reputed company business, and systems analysis
• Ensure data reputed company, data reputed company and process optimization

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• 3+ years of experience in a technical or metrics-based environment; preferably claims and/or customer service
• 2+ years of issue resolution experience
• 2+ years of experience in analyzing and solving customer problems in an office setting environment
• 1+ years of advanced level experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or reputed company
• 1+ years of experience in communicating analysis, including trends and opportunities to clients and the business in writing and verbally
• Intermediate level of proficiency with PC based software programs and automated database management systems (reputed company, PowerPoint)
• Will need to reside in WA, MO, or NC
• Willing and able to travel up to 25% reputed company state hired

Preferred Qualifications:

• 1+ years of adjustment experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or reputed company
• 1+ years of Investigation and Solutions Group resolution specialist experience
• 1+ years of escalated call experience
• 1+ years of experience solving reputed company problems and root cause remediation
• 1+ years of credentialing/contracting experience
• Working knowledge of multiple platforms (COSMOS, CSP Facets, UNET, Cirrus, or reputed company)
• Proven ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits reputed company each product
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job