Provider Service Representative I

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option. WeShare Health is that option. WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point. Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit. WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work® by our employees. If you have a bias for action, enjoy challenges, and want to challenge the status quo to make an impact in a massive industry, WeShare Health might be the place for you!

About the role

The Provider Service Representative at UHSM plays a vital role in building and maintaining positive relationships with healthcare providers, facilitating communication, and ensuring accurate and timely processing of medical billings and inquiries. This entry-level position offers an excellent opportunity for individuals seeking to launch their career in the healthcare industry and make a meaningful impact on the lives of others.

Responsibilities

• Provider Relationship Management: Manage high volume of inbound/outbound calls, emails, and chats to assist healthcare professionals with inquiries and requests, ensuring timely and accurate resolution.
• Provider Relationship Management: Communicate UHSM's policies, procedures, and requirements to providers in a clear and professional manner.
• Provider Relationship Management: Collaborate with internal teams to coordinate provider contracting, credentialing, and network management activities.
• Medical Billing Processing and Resolution: Review and process provider medical billing submissions accurately and efficiently, ensuring adherence to regulatory guidelines and company policies.
• Medical Billing Processing and Resolution: Investigate and resolve medical billing discrepancies, denials, and appeals in a timely manner, working closely with internal stakeholders and providers to achieve resolution.
• Data Entry and Documentation: Accurately enter provider data, medical billing information, and other relevant details into the company's database systems.
• Data Entry and Documentation: Maintain thorough and organized documentation of provider interactions, claim resolutions, and other pertinent information.
• Customer Service and Support: Assist members and providers with inquiries related to benefits, coverage, medical billing status, and other healthcare-related matters.
• Customer Service and Support: Provide exceptional customer service by addressing inquiries promptly, professionally, and courteously.

Qualifications

Required:

• High school diploma or equivalent.
• 6+ months of experience in a customer service role, working with high volume of calls.

Preferred:

• Bachelor's degree.
• Strong communication and interpersonal skills, with the ability to effectively interact with healthcare providers and internal teams.
• Detail-oriented and highly organized, with a focus on accuracy and efficiency in data entry and documentation.
• Customer service mindset, with a commitment to delivering excellent service to providers and members.
• Ability to multitask and prioritize tasks in a fast-paced environment.
• Proficiency in Microsoft Office Suite and experience with database systems (experience with healthcare-specific software a plus).

Benefits

• Competitive hourly pay
• Health, dental, vision, and 403(b) retirement plan
• Ability to make important enhancements to the healthcare industry