This is a remote position based in Arizona and Texas only.
Job Summary
Coordinates incoming correspondence in Provider Services; including reviewing and researching the issue/request, maintaining a log of all requests received, and electronically distributes all requests to the appropriate department/staff within expected timeline(s). Ensures all provider agreements received in Provider Services are appropriately and timely scanned/imaged into the contract management system; including reviewing the agreement for any redlined changes, maintaining a log of all agreements received and quality controls the agreement image.
Education & Experience
Required:
- High School Diploma or GED
- 2 years of varied responsible experience with computer database programs
Preferred:
- 2 years data entry experience
- Experience using provider data management system and/or contract management system(s)
- Experience working for a managed care program or health care provider
Key Responsibilities
- Effectively communicate through writing and/or by phone when contracting internal and external customers in order to triage and bring resolution to incoming workload.
- Review/research all contact notes receives in Provider Services; electronically distributes to appropriate department/staff within expected timeline(s).
- Review/research all incoming inter-office mail and external correspondence for provider data correction requests and distribute to appropriate department/staff.
- Reviews/researches all provider agreements received in Provider Services for accuracy and completeness, identifying any inappropriate redlined changes. Recognize issues with agreements and determine appropriate handling.
- Maintains a log of all provider agreements received in Provider Services.
- Scans/images all provider agreements received in Provider Services; applies quality controls to ensure image quality.
- Assist with development and updating of protocols and desk procedures.
- Triaging and tracking issue resolution to completion.
- Perform other duties as assigned.
Competencies
Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.
Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.
Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.
Technical Skills: Thorough knowledge and complete understanding of the credentialing process and requirements; proficient with Word, Excel, Visual Cactus 3.0, and the ability to produce reports through querying; working knowledge of the VA policies and procedures outlined in the VA Operations manual, VA Policy Manual, DoD Regulations, and the TriWest Central Region RFP.
Working Conditions
Working Conditions:
- Availability to cover any work shift
- Works within a standard office environment
- Extensive computer work with prolonged periods of sitting
- Department of Defense security clearance