Provider Relations Representative jobs in Hawaii

Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. Typically requires a bachelor's degree. Being a Provider Relations Representative typically reports to a supervisor or manager. The Provider Relations Representative works on projects/matters of limited complexity in a support role. Work is closely managed. To be a Provider Relations Representative typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Provider Customer Service Representative - Remote in HI
  • UnitedHealth Group
  • Honolulu, HI FULL_TIME
  • If you are located within the state of Hawaii, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

    At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

    The Provider Customer Service Call and Chat Representative will be supporting providers that care for our members. They are responsible for providing responses to questions that may include Benefits and eligibility, Billing and payments, Clinical Authorizations, EOB, and Behavioral health either by phone call or concurrent chat.

    This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:35 AM - 5:05 PM HST. It may be necessary, given the business need, to work occasional overtime (during peak season), weekends, and / or some holidays.

    We offer 12 - 14 weeks of paid training. The hours during training will be 8:35 AM - 5:05 PM HST from Monday - Friday. Training will be conducted virtually from your home.

    *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

    Primary Responsibilities:

    • Serves as the advocate for providers by demonstrating accountability and ownership to resolve issues
    • Service Providers in a multi - channel environment including call, concurrent chat, as required
    • Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices) 
    • Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health)
    • Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls / messages, escalations, and provider dissatisfaction
    • Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner
    • Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types  
    • Influence providers to utilize self - service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution

    You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications:

    • High School Diploma / GED OR equivalent work experience
    • 1 years of customer service experience with analyzing and solving customer’s concerns
    • Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
    • Ability to type at the speed of greater than OR equal to 35 - 40 WPM with an accuracy of 90% 
    • Ability to work any full-time (40 hours / week) shift between the hours of 8:35 AM - 5:05 PM HST from Monday - Friday including the flexibility to work occasional overtime (during peak season), weekends, and / or some holidays based on business need
    • Must be 18 years of age OR older

    Preferred Qualifications:

    • Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools
    • Prior health care experience and knowledge of healthcare terminology

    Telecommuting Requirements:

    • Reside within the state of Hawaii
    • Ability to keep all company sensitive documents secure (if applicable)
    • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
    • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

    Soft Skills:

    • Ability to multi - task, including the ability to type in multiple conversations
    • Ability to resolve calls and messages, avoiding escalated complaints
    • Time management skills
    • Emotional Intelligence and Empathy
    • Active Listening and Comprehension
    • Excellent written communication skills
    • Demonstrated problem solving, organization, and interpersonal skills
    • Demonstrated experience consistently achieving quality and productivity standards

    Hawaii Residents Only: The hourly range for this is $16.54 - $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

     

    Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

    UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

    #RPO

  • 18 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Mia Migita - State Farm Agent
  • Honolulu, HI FULL_TIME
  • Position Overview Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the ...
  • 18 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Kelii Mawae - State Farm Agent
  • Wailea, HI FULL_TIME
  • Position Overview: Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the...
  • 19 Days Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Brandon Kim - State Farm Agent
  • Waipahu, HI FULL_TIME
  • Position Overview: Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the...
  • 1 Month Ago

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Customer Relations Representative - State Farm Agent Team Member
  • Cheryl Kim - State Farm Agent
  • Honokaa, HI FULL_TIME
  • Position Overview: Are you outgoing and customer-focused? Do you enjoy working with the public? If you answered yes to these questions, working for a State Farm independent contractor agent may be the...
  • 1 Month Ago

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Musculoskeletal Radiologist
  • Provider Solutions & Development
  • Honolulu, HI OTHER
  • Join the largest hospital in Hawaii as an employed Musculoskeletal Radiologist for The Queen’s Health System in Honolulu, working at a major tertiary referral hospital and level 1 trauma center. The Q...
  • 3 Days Ago

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Provider Relations Representative
  • American Health Partners
  • Sparta, GA
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 6/11/2024 12:00:00 AM

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Provider Relations Representative (Bilingual Chinese)
  • Clever Care Health Plan
  • Arcadia, CA
  • Wage Range: $24.00/hr - $28.00/hr Job Summary This position serves as an integral member of the Provider Relations and C...
  • 6/11/2024 12:00:00 AM

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Provider Relations Representative
  • American Health Plans
  • Milledgeville, GA
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 6/10/2024 12:00:00 AM

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Provider Relations Representative
  • Arkos Health
  • Gilbert, AZ
  • This is an in-office position with minimal travel in the field. Our Organization: Welcome to Arkos Health! We are a valu...
  • 6/10/2024 12:00:00 AM

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Provider Relations Representative - Oxnard, CA
  • UnitedHealth Group
  • Oxnard, CA
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 6/10/2024 12:00:00 AM

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Provider Relations Representative
  • Phoebe Physicians
  • Albany, GA
  • Description JOB SUMMARY Serves as a liaison between PHP providers and the organization to meet provider network services...
  • 6/8/2024 12:00:00 AM

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Provider Relations Representative
  • Volunteers of America National Services
  • Eden Prairie, MN
  • Volunteers of America National Services- PACE is seeking a Provider Relations Representative to service our Colorado Ser...
  • 6/8/2024 12:00:00 AM

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Provider Relations Representative
  • American Health Plans
  • Boise, ID
  • American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Instituti...
  • 6/7/2024 12:00:00 AM

Hawaii (/həˈwaɪi/ (listen) hə-WY-ee; Hawaiian: Hawaiʻi [həˈvɐjʔi]) is the 50th and most recent state to have joined the United States, having received statehood on August 21, 1959. Hawaii is the only U.S. state located in Oceania, the only U.S. state located outside North America, and the only one composed entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean. The state encompasses nearly the entire volcanic Hawaiian archipelago, which comprises hundreds of islands spread over 1,500 miles (2,400 km). At the southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Relations Representative jobs
$56,228 to $71,938