Job Information

AdventHealth Physician Network Specialist in Maitland, Florida

Description

Location Address: 902 Inspiration Avenue, Altamonte Springs, Florida 32714

Top Reasons To Work At AdventHealth Corporate

  • Great benefits

  • Immediate Health Insurance Coverage

  • Career growth and advancement potential

Work Hours/Shift:

  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Answers telephone calls from FHHS network providers, who are not in the CIN (AH Clinically Integrated Network). If called by a CIN provider, documents and assigns to the appropriate CIN outreach team.

  • Assists providers and PMAs with obtaining, and routing credentialing/ recredentialing information to other PHSO teams as needed.

  • Documents incoming calls about claims issues and assigns to the appropriate PMA.

  • Monitors SalesForce Cases sent to the Provider Outreach Team from Credentialing, Contracting and/or the Member Experience Center.

  • Identifies/documents opportunities for improvement with interdepartmental processes between the Provider Outreach Team and other PHSO departments.

  • Reviews provider term notifications from Contracting and distributes to PMAs.

  • Assists with claim research requests from providers.

  • Conducts audit reports from SalesForce data to detects missing files (ie; W9s)

KNOWLEDGE AND SKILLS REQUIRED:

  • Ability to talk clearly with providers and their office support staff

  • Ability to answer calls quickly and check for voice-mail messages at least 4 times/day

  • Ability to quickly learn software programs and web-based applications such as SalesForce

  • Ability to collaborate with leadership and PHSO team members

  • Ability to work independently with minimal supervision

  • Exhibits excellent organizational skills and attention to detail

  • Basic capabilities using Microsoft Office applications

Qualifications

EDUCATION AND EXPERIENCE REQUIRED:

  • Associate degree or equivalent work experience

  • 1+ years’ experience in customer service and/or incoming/ outgoing phone calls

Job Summary:

The Provider Operations Specialist provides support to FHHS-only network providers. The person in this position handles incoming and outgoing calls to network providers for Claims, Credentialing, Contracting, and educational opportunities and then follows up with Provider Outreach and Engagement Population Management Advisors (PMAs) and/or other PHSO departments as needed. The Provider Operations Specialist must utilize SalesForce to track communication and follow up as needed for network providers and assign cases, as appropriate in SalesForce, to PMAs and other PHSO teams.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Category: Population Health

Organization: AdventHealth Corporate

Schedule: Full-time

Shift: 1 - Day

Travel: PHSO

Req ID: 21036398

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.