Provider Relations Associate

The role of Customer Service Representative (Level 2) is primarily responsible for providing attentive customer services to providers. The representative will provide timely and accurate responses in a professional and courteous manner utilizing defined processes and guidelines. Responsibilities include answering routine inquiries, resolving issues, and delivering exceptional customer experiences.

Essential Functions :

• Using top-notch interpersonal skills, being able to understand customers’ inquiries or complaints and deal effectively with callers who may be frustrated or angry.
• Handling inbound calls / outbound calls, voicemails, and emails from providers regarding a variety of requests related to benefits, eligibility, network / authorizations, claims inquiry, claims escalations and reconsiderations / appeals.
• Demonstrating and maintaining professional oral and written communication with customers, co-workers and other stakeholders.
• Navigating multiple databases simultaneously to research and create resolutions for providers.
• Possess a professional and friendly attitude and be able to quickly develop a rapport with customers over the phone.
• Using excellent listening skills with the ability to ask probing questions, understand concerns, and overcome objections.
• Identifying, researching, and resolving customer issues using different databases.
• Follow-up on customer inquiries not immediately resolved.
• Consistently meeting established performance and quality standards.
• Participate in recommended or required continuing education seminars and training sessions as needed.

Additional Functions :

Knowledge, Skills, and Abilities :

Physical Demands & Requirements :

Work Environment :

Benefits :

Shift Timings : US Shift – 8AM to 5PM (EST, CST, MST, PST). Based on business requirements.