Description
Providence is seeking a Technical Specialist:
The Customer Service Technical Specialist is responsible for improving the quality of service provided to Health Plan members and practitioners on the service teams through quality analysis, training and other activities.
The work will focus on defining and assessing individual and health plan performance against established indicators, developing and revising training and documentation to improve identified performance gaps, and identifying and leading quality improvement projects to streamline and improve health plan business processes.
Performs all duties in a manner which promotes team concept and reflects the Sisters of Providence mission and philosophy.
In this position you will have the following responsibilities:
Excellent organizational, analytical, problem solving skills and decision-making capabilities required.
Ability to lead cross-functional project teams independently.
Demonstrated teaching, coaching and leadership skills.
Ability to provide technical direction for multiple personnel.
Superior interpersonal and communication skills, both verbal and written.
Medical Coding knowledge required with ability to understand complex claims.
Familiarity with data entry, word processing, database and spreadsheet programs.
Attention to detail is critical.
Extensive knowledge of operational processes within the Health Plans.
Ability to handle multiple priorities independently
Must be able to coordinate multiple assignments with tight deadlines requiring outstanding time management and prioritization skills.
Must demonstrate expertise in all Service Specialist principal duties and functions.
Train (OJT) or re-train service specialists as necessary based on experience, results of quality review programs and external changes or demands. (e.g., new regulations or process changes)
Work with Service Specialists to resolve difficult transactions and problems, guiding them to use the Knowledge Management System rather than simply answering the question.
Modify policy and procedure documentation to improve results or reflect required change
Assists Service Specialists by taking escalated calls and resolves these calls whenever either appropriate or possible.
Serves as operational liaison with other PSJH organizations and departments, employer groups, regulatory agencies and outside vendors on projects or activities.
Delivers feedback and coaching in an effective and respectful way to teammates and peers
Effective management of team resources and key team metrics. Consistently monitors team call volume and average speed of answer. Deploys team resources in response to need as appropriate. Takes incoming customer service calls when all team resources are exhausted.
Other duties as requested or assigned.
Serves as primary backup for team management decisions
Facilitates, supports, and models team decisions; expands and coaches teamwork. Anticipates and influences change using leadership principles. Builds trust and inspires teamwork. Influences others to use their talents to achieve a common goal. Integrates the functions of the customer needs with other areas of the health plan. Team development , accountability and organization of team work schedules.
Proficient use of Facets required
Required qualifications:
- 2 years health insurance operations experience.
Preferred qualifications:
- Bachelor's Degree or a combination of equivalent education and experience.
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.
We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.
We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.
Requsition ID: 177421
Company: Providence Jobs
Job Category: Operations & Support
Job Function: Information Technology
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 OPS CUSTOMER SERVICE ASO OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Pay Range: $25.74 - $40.96
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
