Join Martin's 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 of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's 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 Martin's Point has been certified as a "Great Place to Work" since 2015.
The Provider Service Representative I is responsible for responding to telephone inquiries from providers & related entities regarding benefits, beneficiary eligibility, plan coverage and other related questions received on our benefits and eligibility line. Representatives provide world-class customer service in a professional and timely manner for all inquiries regarding both the Martins Point USFHP and Generations Advantage programs.
Job Description
PRIMARY DUTIES AND RESPONSIBILITIES
Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.
- Answers verbal, written and electronic inquiries with complete and accurate information regarding Martin’s Point USFHP and Medicare program.
- Provides additional training when applicable to callers related to policies, procedures and existing 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 as 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 inquiries with accurate and detailed information, following all applicable workflows and as well as departmental and regulatory requirements.
- Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.
- Other duties as assigned
POSITION QUALIFICATIONS
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.
Education
- High School Diploma or equivalent.
Experience
- 3+ years of customer service experience.
- Previous experience in a medical billing position preferred.
Skills
- Excellent customer service skills
- Analytical skills in research and problem resolution.
- Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).
- Well-organized with excellent follow-up skills.
Abilities
- Demonstrates an understanding of and alignment with Martin’s Point Values.
- Ability to work efficiently and independently.
- Ability to talk and type.
- Active Listener
- Able to work cooperatively with other departments.
- Multi-task oriented with the ability to prioritize.
- Detail oriented.
- Ability to handle stressful situations and can easily adapt to change.
This position is not eligible for immigration sponsorship.
We are an equal opportunity/affirmative action employer.
Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [email protected]
Do you have a question about careers at Martin’s Point Health Care? Contact us at: [email protected]
Skills Required
- High School diploma or equivalent
- 3+ years of customer service experience
- Previous medical billing experience
- Excellent customer service skills
- Analytical skills in research and problem resolution
- Strong computer skills, keyboard proficiency and accurate data entry
- Well-organized with excellent follow-up skills
- Ability to work efficiently and independently
- Ability to talk and type / multitask
- Active listening skills
- Ability to work cooperatively with other departments
- Detail oriented and able to handle stressful situations and adapt to change
What We Do
Martin’s Point Health Care is an innovative not-for-profit health care organization offering high-quality, affordable health care and coverage to the people of Maine and throughout New England. Martin’s Point has seven health care centers in Maine and New Hampshire offering primary and specialty care to those with most major health insurance plans. Martin’s Point also administers two health insurance plans: Generations Advantage—with the only 5-Star Medicare Advantage plans in northern New England, and the US Family Health Plan for active duty military families and retirees throughout most of northern New England and New York. We believe that understanding both the clinical and health plan administrative side gives us the insight we need to make meaningful improvements to the health care system. Martin’s Point is dedicated to creating a community of healthy people through authentic relationships and trust
