Provider Relations Specialist

Provider Relations Specialist

The OccuNet Company is an innovative company striving to reduce the cost of healthcare. We are a passionate group of people that care about affordable access to healthcare without sacrificing experience. We strive to make healthcare more intelligent, streamlined, and cost-effective. We offer industry-leading capabilities on negotiations-driven levers to contain rising healthcare costs while taking an experience-centric approach improving the health and well-being of those we serve. We pride ourselves on our tight knit culture based on the 'outward mindset' philosophy, emphasizing empathy, mutual respect, and seeing each other as "whole people." We have an ambitious vision and are growing quickly. We are seeking team members who are excited about our growth, seeking to thrive in a fast-paced environment, and enthusiastic about developing their skills and career alongside us.

Job Summary

As the Provider Relations Specialist, you will collaborate with medical providers and clients to resolve billing inquiries and disputes.

What it's Like to Work Here

At OccuNet, you matter like we matter! Our team members share a positive attitude, an outward mindset, problem-solving abilities, and patience, enabling them to provide excellent customer service even during challenging situations. Our culture, plus continuous opportunities for growth, has resulted in an industry-low turnover rate. Don't miss out on this rare opening with us!

Duties & Responsibilities

• Evaluate and respond to disputes from medical providers regarding claim processing and/or billing.
• Identify the issue at hand and determine the actions required to resolve the matter based on independent research and sound judgment.
• Follow up with medical providers as needed to ensure agreed upon actions are carried out (i.e., balance adjustments).
• Obtain new or missing documentation from medical providers and/or clients to ensure successful processing of medical bills.
• Respond to routine help desk inquiries from medical providers and clients, including status updates and pricing questions.
• Collaborate with internal colleagues to ensure consistent messaging and solution delivery for all clients and medical providers.
• Diligently adhere to all HIPAA laws, rules, and regulations.
• Maintain confidentiality of sensitive information.
• Perform other duties as assigned.

Required Skills and Abilities

• Strong understanding of medical cost containment products including but not limited to reference-based pricing, out-of-network, and pharmacy benefits manager solutions.
• Knowledge in medical claims including CPT and ICD 10 coding, billing, or general medical insurance preferred.
• Excellent communication and interpersonal skills, written and verbal, with the ability to adapt appropriately for different audiences.
• Excellent time management and organizational skills.
• Able to multi-task effectively, transition between tasks frequently, and maintain focus when presented with interruptions.
• Strong computer skills, with a working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook, OneNote) and comfortability learning and navigating new systems.
• Investigative mindset, with the ability and drive to conduct independent research as needed.
• Adaptable to change.
• Team-first mindset with a high level of motivation, drive, and a desire to learn.
• Passionate and proactive about contributing to organizational missions with an emphasis on improving client and medical provider experiences.
• Strong attention to detail.
• Persistent and motivated to find a solution.
• Comfortable working in a fast-paced environment.
• Prolonged periods sitting or standing at a desk and working on a computer.
• Full-time, Monday to Friday 8 am 5 pm CST.
• On-site, in-person working location in Amarillo, TX.

Culture and Opportunities

• We pride ourselves on our outward mindset supporting each other and putting the team and the clients we serve first
• High-growth environment with clear opportunities for career growth
• Welcoming atmosphere and culture

Benefits

• 401(k) with matching
• Dental insurance
• Health insurance
• Vision insurance
• Health savings account
• Paid time off