[Hiring] Provider Relations Advocate I @6 Degrees Health Dx

Role Description

The Provider Relations Advocate I will act as the primary point of contact for our healthcare providers across the country. This role will focus on ensuring that our health care providers are supported beyond expectations, as well as facilitating resolution of payment and contract disputes between the providers and health plans. This is a remote position.

• Support a culture that is consistent with 6 Degrees Health values and beliefs
• Negotiate settlement of payment disputes with healthcare providers using industry standards and our own data platform
• Resolve healthcare provider access issues and urgent access issues through education and provider contracting
• Proactively reach out to educate healthcare providers in new markets, ensuring a smooth transition for new plans
• Back up to perform initial provider outreach for newly created cases
• Effectively communicate with healthcare provider contacts to explain the benefits of 6 Degrees Health
• Document all communication, account notes, and contact info in online Salesforce, spreadsheets and systems used within 6 Degrees Health
• Adhere to patient confidentiality requirements and other company policies
• Other responsibilities or projects as assigned

Qualifications

• Excellent verbal and written communication skills
• Excellent organizational and prioritization skills with an ability to operate in ambiguous situations
• Demonstrates ability to quickly learn and adapt to new ideas and processes
• Detail oriented
• Ability to effectively adapt in a dynamic, fast paced environment
• High School Diploma or equivalent
• College Degree or equivalent work experience preferred

Requirements

• 2+ years customer service experience
• Negotiation or mediation experience; 2+ years preferred
• Medical/Pharmacy Claims Audit/Examination
• Medical coding experience strongly preferred
• Experience in medical records, medical billing, medical coding, medical assistants, CNAs, LPNs
• Must have the ability to read and understand various process flows and procedures
• Strong internal and external communication skills, both verbal and written
• Must be willing and able to work a 5-day schedule and additional hours beyond regularly scheduled shift to cover vacancies, if necessary
• Must be able to sit or stand for two hours at a time
• Must be able to operate computers and phones to support position requirements
• Strong Microsoft Office Skills are a must

Benefits

• Medical, Dental, Vision and Other Outstanding Ancillary Benefits
• Training and Development Opportunities
• Paid Holidays
• 401k Program with 3% employer match
• Remote Work Stipend
• Unlimited Paid Time Off
• Calm App Premium Membership