Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The Provider Services Representative I serves as the primary point of contact between healthcare providers and the organization and is responsible for assisting providers with a wide range of needs and resolving issues associated with our Utilization Review Program.
Your role in our mission
- Understands end to end provider experience and issues for multiple Utilization Review contracts.
- Professionally assists providers with incoming questions (telephonically, via email, or portal message) associated with our Utilization Review Program
- Onboards new providers and users to provider portal and assist with training or walk-through site as needed.
- Researches provider issues in various systems, follows up with different departments as needed, and ensures timely response back to providers.
- Performs outreach to providers according to contract timeline to ensure that missing medical records are sent in timely, along with performs other ad hoc call out requests to the providers.
- Ensures that documents received electronically are processed timely.
- Manages data management system ensuring that all providers contact within the department is documented timely and accurately.
- Assists with implementing training for internal staff and development of enhanced provider service processes.
- Abides by service level agreements (SLAs) for various tasks and ensure that key performance indicators for department are met.
What we're looking for
- Two or more years of utilization review, healthcare call center, hospital claims support, or clinical customer support experience
- Familiarity with computers and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
- Experience with Microsoft Word (create/edit documents), Microsoft Excel (create/edit spreadsheets), and Microsoft Outlook (send/receive emails)
- Outstanding communication skills both verbal and written to effectively interact with providers and internal teams.
- Ability to problem solve and analyze issues to provide efficient, accurate resolutions to provider inquiries.
- High School Diploma or GED required.
What you should expect in this role
- Remote in All USA Location
- #LI-NA1
- #LI-Remote
The pay range for this position is $25,300 - $36,200 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
