Job Description

Position Summary:

The Provider Portal Specialist plays a key role in driving utilization of provider self-service tools. Responsible for processing provider portal applications in a timely and accurate manner and promoting provider understanding of portal functionality and navigation. This includes managing provider calls, emails, and maintaining all provider educational materials current.

Essential Duties and Responsibilities:

1. Manage provider office inquiries and end-user support requests via email and telephone queue.
2. Review all provider portal applications to verify eligibility for portal access; and identify, address, and resolve discrepancies on applications.
3. Prepare accurate and complete data files and send timely to IT partners.
4. Perform post-access review and work with IT partners to ensure accurate user account setup.
5. Support provider office staff through the portal application process, promoting successful login and use of portal, following all applications through all process setups until full resolution.
6. Proactively and reactively promote provider understanding of portal function and navigation, escalating complex questions/ issues to supervisor when indicated.
7. Interact with all internal and external customers in a professional and courteous manner, using approved standard responses and scripting externally when applicable.
8. Document all provider interactions as per standard operating procedure.
9. Maintain all provider materials and communications current, updating and enhancing when applicable.
10. Identify and promote opportunities to improve end-user experience.
11. Maintain enrollee and provider confidentiality by following HIPAA rules and regulations, as well as internal compliance policies.
12. Other duties as assigned.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.

Skills and Abilities:

• Attention to detail and accuracy
• Ability to provide excellent customer service
• Problem solving
• Consistently produce high-quality work product
• Time management and prioritization
• Excellent follow through
• Excellent communication
• Professionalism
• Ability to work in a fast-paced environment
• Flexibility with changing responsibilities
• Demonstrated mastery in effectively managing and prioritizing multiple tasks
• Strong verbal and written communication skills
• Ability to work independently and effectively interact with internal and external customers

Work Schedule:

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule. Staff are able to work from home 3 days a week and will report to the office 2 days a week. *****The company reserves the right to change the work schedules based on the company needs.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic, travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity and inclusion.

Qualifications

• Associate's degree in health care related field preferred; or High School Diploma with minimum 3-5 years of healthcare industry related experience
• Knowledge of Microsoft Excel, word processing software, database software, and Electronic Medical Record Navigation
• Preferred: 2-3 years of experience in healthcare setting
• Experience in data processing in a healthcare setting (Priority)

Additional Qualifications :

• Knowledge/experience working in a Medical Office
• independent and organized worker
• successfully multitask the workload (required)
• for example (not limited too): work phone calls, troubleshooting portal issues, and granting permissions
• IT Help Desk Skills (preferred +++)

Job Tags

Similar Jobs