Located in Alexandria, Minnesota, just over two hours northwest of Minneapolis-St Paul on I-94, you have the opportunity to work and live where thousands come to play and vacation in the heart of lake country. Take a boat out on one of our 350 lakes in the summer and trade it in for an icehouse in the winter. In all seasons, you can hike a trail in Lake Carlos State Park or hike through our unique downtown shopping district. Alexandria is easy to find but hard to leave!
This position is responsible for performing a variety of administrative and clerical tasks for the Provider Services team. This person will provide direct support to the team including assistance with collecting documents from providers, conducting phone surveys, performing daily office tasks, coordinating transportation, and other tasks as assigned.
Role and Key Responsibilities
Assist the Provider Services Manager and PrimeWest Health staff in the following as needed:
1. Provider Outreach
a. Maintain up-to-date documents from providers
b. In collaboration with Provider Services staff, collect necessary documents or information from contracted providers
c. Receive provider documents and distribute as necessary
d. File reports submitted to PrimeWest Health
2. Provider Appeals
a. Assist with provider Appeals when necessary
i. Print letters, review paper Appeals, and monitor for any member Appeals received
ii. Reconcile Appeals received for other lines of business
iii. Receive and track provider Appeals, including researching and reviewing documentation submitted with the Appeal
iv. Review and determine outcome of provider Appeals per policy and desktop procedure, exercising discretion and independent judgement
3. Provider Surveys
a. Conduct provider outreach regarding the following required surveys:
i. Provider Compliance Attestation
ii. Ownership Disclosure
iii. Access to Care
4. Transportation
a. Assist with any transportation scheduling not done by our transportation coordinator
b. Review invoices and billing from transportation coordinator
c. Provide general customer services for providers
d. Track transportation coordinator’s progress with requested upgrades
This is a flexible position that requires at least two days a week in the office in Alexandria, Minnesota.
PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion