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Provider Service Specialist (Guide)

| Waltham
A bit about us: 
We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being. 
That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly. 
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
Provider Service Guide:
As a Provider Service Guide, you will serve as the primary Devoted Health contact for health care providers to resolve issues relating to services those providers are delivering for our members. The Provider Service Guides provides exceptional customer service responding to inquiries from providers You will answer questions from providers regarding what services are covered under our plans and the status of their medical claims. You will also help to educate providers on Devoted Health policies and procedures to include products, benefits, claims, referral and eligibility verification processes, utilization management guidelines, etc. As a Provider Service Guide you will conduct research and work with the rest of the Devoted Health team to resolve provider issues. You will work collaboratively with internal partners to reduce provider issues and implement long term solutions to problems identified.

Responsibilities will include:

  • Identifies and resolves provider issues by researching causes and working with Devoted Health’s clinical and operations teams
  • Responds to provider calls on the Provider Services Line queue as well as emails, voicemails and faxes seeking assistance
  • Utilizes necessary resources and navigate systems efficiently to accurately verify eligibility and provide verification of benefits
  • Assist providers in using Provider Portal

Attributes to success:

  • You have the ability to articulate Devoted policies and procedures
  • You enjoy research and working with teams to resolve issues
  • You have an approachable and professional communication skills- both written and oral
  • A comfort level with discussing Devoted Health with providers and their staff
  • You enjoy interacting with providers in their staff to discuss Devoted Health

Desired skills and experience:

  • Bachelor’s degree or equivalent experience in health care
  • 2-3 years Customer Service experience
  • Previous data entry experience required
  • Very strong verbal and written communication skills
  • Must be detail oriented and able to work independently in a fast changing environment
  • Strong understanding of Medicare and healthcare operations

If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you! 
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

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Our sunny office is in the beautiful Watch Factory alongside the Charles River in Waltham. It's easily reachable by commuter train, bus, or bike.