TheProvider Services Specialist is responsible for the full range of providerrelations and service interactions within SWHP, including working on end-to-endprovider claim and call quality, ease of use of provider portal and futureservice enhancements.
* Thisposition may be asked to manage all administrative aspects of provider issueresolution.
* TheProvider Services Specialist responds to physician, hospital and ancillaryprovider inquiries and requests for services associated with the resolution ofprovider complaints, claim processing, appeals issues, and various operationalconcerns.
*Interprets SWHP policies and facilitates the research required to resolveprovider issues.
* TheProvider Services Specialist will assist the data analyst in the review ofprovider directories in order to maintain data integrity.
* Alsoupdates provider information in Cactus and assists with reporting asneeded.
* Receivecalls and correspondence from physicians, hospitals and ancillary providersrequesting information and services.
* Act asprimary point of contact with providers by promoting a one-stop customerservice.
* Indentifyappropriate internal resources in order to resolve issues.
*Facilitate business activities through triage and coordination of resourcesaccording to priority of need.
* Monitorstatus of resolution through maintaining detailed documentation of issue andaction to date.
* Conductproactive follow-up activities with provider and/or SWHP staff.
* Adhere todepartmental and organization standards (service level, issue resolutiontimeframes)
* Assistand support Provider Services Representative on project assignments such asclaims and referral issues, welcome letters and in the education of providerson SWHP policy and procedures.
* Escalatecritical issues and conflicts to Director of Provider Relations or ProviderServices Representative.
*Participate in departmental and interdepartmental meetings as appropriate andnecessary.
*Participate in ad hoc projects as necessary.
* Maintainprofessional growth and development through self directed learning activities.
* Thisposition reports directly to the Director of Provider Relations.
Â§Location/Facility â Austin,Texas
For more information on the facility, please click our Locations link.
Ã¼Immediate eligibility for health and welfare benefits
Ã¼401(k) savings plan with dollar-for-dollar match up to 5%
Ã¼PTO accrual beginning Day 1
*Note: Benefits may varybased upon position type and/or level.
Baylor Scott & White Health(BSWH) is the largest not-for-profit health care system in Texasand one of the largest in the United States. With a commitment to and atrack record of innovation, collaboration, integrity and compassion for thepatient, BSWH stands to be one of the nationâs exemplary health careorganizations. Our mission isto serve all people by providing personalized health and wellness throughexemplary care, education and research as a Christian ministry of healing.Joining our team is not just accepting a job, itâs accepting a calling!
Associates degree or equivalent
5 years experience
Internal Number: 19006662
About Baylor Scott & White Health
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!