What are the responsibilities and job description for the Provider Relations Representative position at Vālenz Health®?
Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.
About Our Opportunity
As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—or customer love as we say!
Things You’ll Do Here:
What You’ll Bring to the Team:
This is a fully remote position, and we’ll provide all the necessary equipment!
Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.
Benefits
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About Our Opportunity
As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—or customer love as we say!
Things You’ll Do Here:
- Facilitate inquiries from providers regarding reimbursement rates.
- Negotiate ongoing and single case agreements (SCAs)
- Direct members to in-network or RBP accepting providers.
- Focus on the member journey and minimizing disruption to providers.
- Develop trust with members and providers to ensure long-term relationships.
- Anticipate and identify issues and escalate to the appropriate manager or team leader.
- Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn-around-times, and success rates.
- Facilitate the appeals process.
- Maintain compliance with company policies and procedures.
- Performs related duties as assigned by supervisor.
What You’ll Bring to the Team:
- 1 years of experience in customer service.
- Experience working independently and completing assignments within given instructions, routines, and accepted practices.
- Excellent verbal and written communication skills.
- Ability to work in a fast-paced, customer focused, and deadline-driven environment.
- Experience working in healthcare environment with providers.
This is a fully remote position, and we’ll provide all the necessary equipment!
- Work Environment: You’ll need a quiet workspace that is free from distractions
- Technology: Reliable internet connection—if you can use streaming services, you’re good to go!
- Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software
- Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA
Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare. With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.
Benefits
- Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card
- Spending account options: HSA, FSA, and DCFSA
- 401K with company match and immediate vesting
- Flexible working environment
- Generous Paid Time Off to include vacation, sick leave, and paid holidays
- Employee Assistance Program that includes professional counseling, referrals, and additional services
- Paid maternity and paternity leave
- Pet insurance
- Employee discounts on phone plans, car rentals and computers
- Community giveback opportunities, including paid time off for philanthropic endeavors
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