Provider Services Representative
OPENING DATE: 05/12/22
CLOSING DATE: 05/19/22 11:59 PM Central Time
JOB TYPE: Full-time
LOCATION: Downtown Minneapolis, Minnesota
DEPARTMENT: Hennepin Health
THE POSITION
Hennepin Health is seeking a Provider Services Representative. This position is responsible for resolving provider issues by responding to inquiries on a day-to-day basis. This encompasses responding to calls from health care providers to help answer questions and resolve issues regarding health care claims and payments. This provides the opportunity to create and positive relationships between the health plan and providers, including physicians, hospitals, larger care systems, ancillary providers, and practice managers.
Location and hours:
Currently, this position is remote due to COVID-19. Once the COVID-19 emergency declaration is lifted, this position may be hybrid and may be performed both on-site at the Health Services Building at 525 Portland Avenue, Minneapolis, MN 55415 (this location is accessible by public transportation and light rail) and remote as job duties require. While temporarily designated as remote, workers may be required to come on-site an average of 0 to 12 days a year for work meetings, trainings, or for any other reasons that their supervisor may deem necessary (may include additional days for onboarding and new employee training). Supervisors will provide as much advance notice as practicable. While this position is designated as hybrid, based on current requirements hires must reside in Minnesota or Wisconsin.
Work hours will be Monday through Friday, 8 a.m. - 5:30 p.m.
New employees who are hired into remote or hybrid positions between January 2, 2022 to December 31, 2024, will receive $500 toward the cost of establishing consistent internet connectivity, payable upon completion of 6 months of employment.
About this position type:
This position is a full-time, benefit earning position.
This position is internally classified as an Administrative Assistant
Effective September 1, 2021, all new job offers are conditional based on the candidate being fully vaccinated for COVID-19. “Fully vaccinated” means 14 days after receiving the second dose in a two-dose vaccination series approved by the U.S. Food and Drug Administration (FDA) on a full or emergency-use basis, or 14 days after receiving a single-dose vaccine approved by the FDA on a full or emergency-use basis. After a conditional job offer is made, the candidate must show proof of full vaccination prior to their start date. A COVID-19 vaccination card from the Center for Disease Control and Prevention (CDC), a vaccination record from your doctor’s office or a personal digital vaccination record constitutes sufficient “proof.” The candidate must also attest they are vaccinated by completing a form on the first day of employment. Reasonable accommodations to this vaccination requirement will be considered upon request by a candidate for medical or religious reasons as required by applicable law.
In this position, you will:
- Answer incoming calls from health care providers; physician offices, clinics, hospitals, and act as a backup to the Member Service team.
- Identify the type of assistance the providers may need including benefits, eligibility, billing and payments, authorizations for treatment and explanation of benefits, and remits.
- Focus on resolving issues on the first call, navigate through the multiple system applications to identify the current status of the issue, and provide an appropriate response to the caller.
- Complete the documentation necessary to track provider issue and facilitate the reporting of overall trends.
- Conduct follow-up calls to the providers regarding issue resolution outcomes.
- Compose correspondence and provider specific reports to trend issues if it affects more than one claim.
Need to have:
- One of the following:
- Four or more years of experience in a Managed Care or Commercial insurance, or in a customer service, claims, or provider support role.
- Bachelor's degree or higher in public administration, business administration, or other field appropriate to the position.
Nice to have:
- Two or more years of experience in a customer service, claims, or provider support role.
- Experience:
- Working with providers, including physicians, hospitals, larger care systems, ancillary providers, and practice managers.
- Providing customer service in a call center setting.
- In claim adjudication and adjustments.
- Working for a health plan with exposure to Minnesota health care programs.
- With coding, billing, electronic data interchange (EDI), revenue cycle management, practice management systems.
- Multi-tasking in a fast paced environment.
- Working with multiple product lines of business with multiple levels of benefits within each product.
- Planning with strong organization skills.
- Ability to:
- Navigate a computer while on the phone.
- Understand multiple system applications.
- Research and use strong analytical skills.
- Strong interpersonal and verbal communication skills including telephone etiquette.
About the department:
Hennepin Health provides health care coverage to Hennepin County residents who are enrolled in a Minnesota Health Care Program. Hennepin Health is a nonprofit, state-certified health maintenance organization that contracts with the Minnesota Department of Human Services. We envision being a leader in partnering with our members and communities to improve health, by integrating health care and service to enhance the health and well being of our members and the community.
About Hennepin County:
Hennepin is the largest county government organization in Minnesota. Our employees work every day to improve the health, safety and quality of life for our residents and communities. All of our jobs align to one or more of our overarching goals -- that Hennepin County residents are healthy, protected and safe, self-reliant, assured due process, and mobile.
Our employees receive a combination of generous benefits and positive workplace culture not found at other organizations. This includes meaningful work that impacts our community, competitive pay, work-life balance, a variety of benefits and opportunities to grow. Learn more at www.hennepin.us/employees.
Hennepin County envisions an organization where our commitment to diversity and the reduction of disparities is fundamental in providing excellent service to our community.
Your future. Made here.
Applications will be forwarded to the hiring supervisor on a regular basis. This posting may be used to fill current and future vacancies.
Will have access to systems or other documentation that contains HIPAA data.
Invitations to interview will be based upon an assessment of education and experience.
Final candidates may be required to complete a background check.