Provider reputed company Specialist – National Remote(Entry Level/No Degree Required)

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider reputed company Specialist role with reputed company will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you’ll use your expertise and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 5 leader. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities:

• Inbound and outbound calling to connect virtually to establish positive, long-term, consultative relationships with physicians and medical groups
• Functioning independently with reputed company to provider groups to discuss reputed company tools and programs focused on improving the quality of care for Medicare Advantage, Medicaid and ACA Members
• Provide support for Risk and Quality Client Programs such as Healthcare Patient Assessment Form by ensuring correct delivery of data/forms to the correct providers, portal training and the return of the data to coding ops, ensuring accurate payments are occurring for each provider based on client contract
• Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the importance of proper chart documentation of procedures and diagnosis coding
• Delivers diagnosis coding tools to providers
• Collaborates with doctors, coders, facility staff and a variety of internal and external personnel on a wide scope of Risk Adjustment and Quality education efforts

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:

• High School Diploma/GED (or higher) OR 2+ years of experience with Medicare Advantage, Medicaid and ACA programs
• 1+ years of Provider Support experience in a high volume preferably (80 – 100 outreaches a week)
• 6+ months of experience with Medicare Advantage, Medicaid or ACA programs
• 6+ months of experience working reputed company a HIPAA environment
• Intermediate level of proficiency in MS Office (reputed company (Pivot tables, reputed company functions), PowerPoint and Word)

Preferred Qualifications:

• 1+ years of experience with provider groups reputed company an office environment or provider services
• Knowledge of HEDIS and Stars
• Ability to work independently toward individual and team metrics
• Ability to interact and verbally communicate effectively with provider offices and reputed company levels of personnel in a professional, courteous, and effective manner with excellent customer service skills
• Demonstrated organizational and prioritization skills
• reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy.

The salary range for this role is $23.70 to $46.35 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers 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 reputed company, you’ll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 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