American Specialty Health Incorporated is searching for an exceptional customer service representative to join our Provider Relations Team. The ideal candidate will professionally respond to practitioner inquires via the telephone queue system regarding credentialing, re-credentialing and contracting to ensure efficient and effective resolution of practitioner inquires or complaints and to deliver high quality customer service.

Responsibilities

• Answers incoming calls in a professional, accurate, timely and courteous manner from the Provider Relations and Credentialing queue.
• Assistspractitioners, staff, and clients with questions regarding credentialing, re-credentialing, participation requirements, contractual issues and high-level administrative problems.
• Performscredentialing and re-credentialing activities according to plan specifications.
• Forwardscomplex requests that require research to the appropriate ASHCore bucket or PRL supervisor to achieve appropriate resolution.
• Captures practitioner complaintsand resolves or forwards to the appropriate ASHCore bucket or PRL supervisor for 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.
• Attendsdepartment and all-staff meetings to increase knowledge and foster teamwork.
• Pull CAQH applications when provider calls in with CAQH number. Drop application in designated folder.
• Download CAQH applications for PTOT practitioners that are being added to a provider.

Qualifications

• Associate's degree or equivalent preferred. High school diploma required.
• Minimum two years of progressive experience performing customer service duties preferred.
• Specialty health care or health care experience preferred.
• Credentialing and re-credentialing experience preferred.
• Proficient in MS Office with experience in word processing and spreadsheet applications.
• General understanding of Provider Relations Guidelines.

Core Competencies

• 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.
• 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.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work from home (WFH) environment..

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

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