Experience in Home Care/Home Health Agencies/ Assisted Living/ Skilled Nursing Facilities/ Adult Day Care
Experience in Provider Networks, Long Term Care process and services (Preferred)
Knowledge and understanding of the Health Insurance Portability and Accountability Act (HIPAA)
2-4 years' experience as a customer experience specialist, provider support, or related role
Responsibilities
Invoice Validation & Processing: Become a subject matter expert (SME) of the CareScout Invoice Validation Process. Remediate invoice discrepancies and resolve issues. Monitor Invoice Queue Maintain/Improve invoice TAT. Maintain awareness of provider experience during invoice processing
Invoice Support & Customer Assistance: Respond to provider inquiries related to invoices via phone, email, social media, and chat. Provide website/application navigation support and update provider accounts and contacts. Guide and support provider by recommending timely and relevant solutions. Educate providers on invoice validation and supporting responsibilities
Collaboration & Process Improvement: Document processes, log issues, and troubleshoot inquiries. Work closely with RVPs, Market Directors, and Provider Operations teams. Partner with credentialing and Network management teams to improve processes. Aligning and rolling out provider marketing initiatives and communications in an omni channel approach. Identify and implement improvements to products, systems, and procedures. Participate in invoice supporting projects
Account & Territory Management: Assume responsibility for assigned territory or national accounts invoice cases. Tracking hard bounce emails, non-entitlement logs, error logs. Address IPA entitlements and manage Assignment of Benefits (AOB) Flags
Data Management & Reporting: Review invoice/ provider support cases and documentation for quality control. Utilize CRM (Dynamics 365) for servicing, transactional support, and maintaining customer and provider account details. Compile and review reports upon request. Capture customer feedback and share insights with customer experience, product management, sales, and network teams
Product Testing & Continuous Improvement: Assist in product testing and evaluate after-sales and support services. Enhance the customer experience by refining processes and identifying opportunities for improvement