Practitioner Relations and Outreach Rep

San Diego, CA 92121

Employment Type: Contract Job Category: Customer Service Job Number: 46750 Pay Rate: 15

Outbound Call Center Representative

The primary purpose of this position is to make outbound calls and educate contracted practitioners participation contract obligations via the telephone to ensure compliance is met efficiently and effectively, and to deliver high quality customer service.

Schedule: Full Time, Monday Friday

Pay: $15/hr

Location: Sorrento Valley San Diego, CA 92121

Education/Training/Experience/Licenses:

  • Associate degree preferred. If equivalent experience, high school diploma required.
  • Minimum two years of progressive experience performing customer service duties.
  • Specialty health care or health care experience preferred.
  • Proficient in MS Office with experience in word processing and spreadsheet applications.

Responsibilities:

  • Outreach to practitioner network of practitioners who have not validated their demographics in order to meet regulatory requirements.
  • Provider screening and data entry for new Medicaid/Medicare regulatory requirements.
  • Handles incoming calls regarding provider directory validation and follow up with response and tracked in to database and/or spreadsheets.
  • Outreach to a list of providers to validate directory listing data for NCQA auditing to ensure regulatory requirements are met for the network.
  • Handles complex responses that require research to achieve appropriate resolution.
  • Captures practitioner change information, documents and forwards as required to record changes in appropriate databases.
  • Handles necessary administrative duties to properly support, document and resolve practitioner inquires.
  • Maintains confidentiality of practitioner files, participation data, practitioner records/documents and all discussions relative to recruiting, contracting, and credentialing processes.
  • Attends department and all-staff meetings to increase knowledge and foster teamwork.

Knowledge/Skills/Abilities:

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment; and strong verbal and written communication skills.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.
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