Provider Inquiry Representative

Join Martins Point Health Care - an innovative not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force ofpeople caring for people Martins Point employees are on amission to transform our health care system while creating a healthier community. Martins Point employees enjoy an organizational culture of trust and respect where our values - taking care of ourselves and others continuous learning helping each other and having fun - are brought to life every day. Join us and find out for yourself why Martins Point has been certified as a Great Place to Work since 2015.

Position Summary

The Provider Service Representative Is major responsibility is to professionally respond to telephone inquiries from providers & related entities. The questions will be concerning but not limited to benefits eligibility plan coverage enrollment status claims adjudication process billing and payments for Martins Point USFHP Program and Medicare programs.

Job Description

Key Outcomes :

• Answers verbal written and electronic inquiries with complete and accurate information and educates when possible regarding Martins Point USFHP and Medicare programs policies procedures and self- service options.
• Responds to incoming inquiries and partners with provider on possible next steps and or resolution. This should be completed within the timeframes outlined in Representative Expectations document.
• Collaborates with PI Research team and or other departments when needed to resolve Provider issues. Follows up in a timely manner with providers when first call resolution is not possible.
• Stays educated on existing and new information available through Provider Services internal resources.
• Documents all provider inquiries with accurate and detailed information according to correct template including the resolution and next steps of the inquiry.
• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.

Education / Experience :

Requirements :

Terms of employment may require the applicant / incumbent to qualify obtain and maintain a Position Level of Trustworthiness from the U.S. Government Office of Personnel Management. Additionally this position may require the applicant / incumbent to be a U.S. citizen.

Skills / Knowledge / Competencies (Behaviors) :

There are additional competencies linked to individual contributor provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

This position is not eligible for immigration sponsorship.

We are an equal opportunity / affirmative action employer.

Do you have a question about careers at Martins Point Health Care Contact us at :

Required Experience :

Unclear Seniority

Key Skills

Data Entry,Deputy,Drafting,Hibernate,Administration Support,Activex

Employment Type : Full-Time

Experience : years

Vacancy : 1