[Hiring] Provider Experience Center Representative @Banner Health

Role Description

As a Provider Experience Representative for Banner Plans & Networks, you will take inbound calls answering questions from providers and their staff members. You will utilize your background in medical billing, medical claims, customer service, and managed care to answer complex questions and find solutions regarding coverage, benefits, and other inquiries.

You will be working in a fast-paced and multitasking environment while providing excellent customer service with a goal of first call resolution. This position is remote, with work shifts Monday-Friday from 8:00 a.m. to 5:00 p.m. Full-time and part-time shifts are available.

Please note that Banner Staffing Services roles do not offer medical benefits or paid time off accrual. These roles are assignment-based with no guarantee of hours, and assignments can conclude at any time. MUST RESIDE IN THE STATE OF AZ.

Core Functions

• Receives, documents, researches, and responds to provider inquiries and escalated calls following established policies and procedures.
• Works cohesively with appropriate parties to ensure delivery of outstanding customer service while facilitating timely research and issue resolution.
• Provides timely and accurate information to providers regarding claims, benefits, member out-of-pocket expenses, and payments.
• Identifies and resolves managed care issues concerning claims, contract interpretation, utilization management, eligibility, and general operational issues.
• Assists internal departments in resolving provider appeals pertaining to the organization’s physicians, hospitals, and insurance plan contracts.
• Works on special projects as assigned.
• Services inbound and outbound communications for all facilities and/or physician offices in the states in which they operate.

Qualifications

• High school diploma/GED or equivalent working knowledge.
• Substantial previous related work experience in healthcare services, with three to four years in a high-volume service center or managed care environment.
• Excellent communication skills, both verbal and written.
• Ability to multitask between inbound calls and searching for correct and timely information.
• Excellent organizational skills and operational knowledge of work processing, spreadsheets, data entry, and other computer-related skills.
• Ability to establish daily work priorities and work efficiently.

Preferred Qualifications

• Strong knowledge of business and/or healthcare, typically obtained through the completion of an associate’s degree.
• Knowledge of medical claims typically acquired over one to two years of work experience in medical claims adjudication, contract interpretations, billing and coding, and medical terminology.
• Additional related education and/or experience preferred.

EEO Statement

EEO/Disabled/Veterans. Our organization supports a drug-free work environment.