Oscar logo
Oscar

Award-winning recruitment consultancy; delivering talent across Tech, Digital, Life-Sciences, Energy & Construction

Member & Provider Care Specialist

Location

Arizona + 2 moreAll locations: Arizona | Florida | Texas

Posted

1 day ago

Salary

$22 / hour

Seniority

Junior

High School1 yr expEnglish

Job Description

Member & Provider Care Specialist

Oscar

• Handle inbound and outbound calls, secure messages and/or email communications with members or providers • Manage queue work and and assigned caseload through efficient dashboard management • Identify, investigate, and resolve issues within determined SLAs • Collaborate with colleagues, Experts, and Leads to identify trends and roadblocks • Utilize internal tools and resources seamlessly • Effectively communicates findings and resolutions with providers and internal departments • Support Member and Provider Services Representatives with complex issues, workflows, and training • Escalate updates or incorrect information in the internal knowledge management system for Member and Provider Services • Partner with production teams across the LifeCycles to improve the member and provider experience • Compliance with all applicable laws and regulations • Other duties as assigned

Job Requirements

  • 1+ years in customer support, healthcare, tech and/or related field
  • Experience in a fast-paced environment
  • 6 + months of member and customer service experience
  • 1+ year of escalations experience in a customer service environment

Benefits

  • employee benefits
  • monthly vacation accrual at a rate of 15 days per year

Related Categories

Related Job Pages

More General Jobs

Exceptional HR Solutions, LLC logo

Prescription Department Specialist

Exceptional HR Solutions, LLC

An advising, consulting & executive coaching company supporting leaders and companies with their people needs.

General1 day ago
Full TimeRemoteTeam 11-50H1B No Sponsor

• Proactively monitoring progress of locked and co-signed charts throughout the day • Call-in or E-fax confirmed prescriptions to pharmacies • Monitor patient chart activity in eCW for locking and co-signing charts by provider • Utilized and comprehends eClinicalWorks • Monitors and tracks established patient prescription authorizations • Ensures payment of prescriptions by verifying insurance coverage and prescription formularies • Submits prior authorizations to insurance companies via phone, fax and electronic systems • Answers incoming calls and addresses patients concerns and/or questions regarding their authorization process • Maintains accurate documentation of authorizations • Works directly with insurance companies, pharmacies and providers • Represents Ideal Option professionally and with a positive attitude • Complies with national PHI laws including HIPAA and 42 CFR Part 2 • Maintains continual sustained attendance

Washington
$17 / hour
Exceptional HR Solutions, LLC logo

Medical Biller

Exceptional HR Solutions, LLC

An advising, consulting & executive coaching company supporting leaders and companies with their people needs.

General1 day ago
Full TimeRemoteTeam 11-50H1B No Sponsor

• Submitting medical claims to insurance companies and payers such as Medicare and Medicaid. • Works directly with the insurance companies, healthcare providers and patients to get a claim processed and paid. • Reviews and appeals unpaid and denied claims. • Processes patient and insurance refund requests in a timely manner and posts payments and/or denials from insurance remits. • Assists patients in getting the correct information to apply for charity/Medicaid or a payment plan. • Uses coded data to produce sub claims to insurance companies. • Maintains knowledge of current billing rules and trends for billing types assigned. • Assists patients in verifying benefit information and assists in patient scheduling and account creation. • Ensures weekly, monthly, and quarterly department goals are met. • Obtains referrals and pre-authorizations as required for procedures. • Checks eligibility and benefits verification for treatments, hospitalizations, and procedures. • Reviews patient bills for accuracy and completeness and obtaining any missing information. • Prepares, reviews, and transmits claims using billing software, including electronic and paper claim processing. • Follows up on unpaid claims within standard billing cycle timeframe. • Checks each insurance payment for accuracy and compliance with contract discount. • Calls insurance companies regarding any discrepancy in payments if necessary. • Identifies any billing secondary or tertiary insurances. • Sets up patient payment plans and work collection accounts. • Updates billing software with rate changes. • Must comply with all elements within HIPAA and the Privacy Act.

United States
$17 - $18 / hour
Full TimeRemoteTeam 10,001+H1B No Sponsor

• Responsible for delivering effective, efficient, and timely delivery of the Company’s line of services to multiple customers within an assigned geographic territory. • Is provided a company van and tools and travels to a variety of customer sites to maintain commercial properties. • Performs preventive maintenance and corrective repairs on buildings, equipment and grounds • Conducts “face to face” relationship with Customers in the service of the client’s requirements. • Utilizes multiple trade skills such as carpentry, plumbing, electrical, painting, and roofing, HVAC, and other skills as needed to solve maintenance problems. • Completes preventative maintenance and repairs per work order requirements. • Self performs the following duties in compliance company procedures, regulatory requirements and safety standards. • Performs minor plumbing maintenance on existing systems (e.g. unclog toilets and drains, repair leaks in drains and faucets, replace toilets and faucet fixtures as needed, etc.). • Performs routine painting, carpentry work, etc., as necessary to maintain our Client’s facilities in like new condition (e.g. repair a hole in dry-wall, prep the area, and match the paint to present a uniform and original like new appearance). • Performs minor electrical maintenance as allowed without a license within state law requirements (e.g. repair or replacement of fixtures, wall switches, and outlets. Replace light bulbs, ballasts and sockets if necessary). • Completes service inspections and asset inspections as needed. • Fully utilizes technology (tablet, smartphone) to: Access and complete work orders including notes on services provided. • Create and submit Service Reports and Quality Inspection images and reports. • Submit timesheets, expense reports, and purchase card logs. • Obtains necessary materials and supplies to complete all tasks. • Creates a positive climate with the client, provides and generates customer satisfaction. • Maintains timely and consistent communications with customer and internal support teams. • Obtains and completes EFS required safety and compliance training and attends weekly safety meetings. • Provides estimates for larger projects and services needed to onsite customer. • Completes other duties as assigned or required.

Michigan
$25 - $30 / hour
Turner & Townsend logo

Senior Mechanical Construction Estimator – HVAC, Plumbing

Turner & Townsend

A global consultancy business serving clients in the real estate, infrastructure and natural resources sectors.

General1 day ago
Full TimeRemoteTeam 10,001+H1B No Sponsor

• Prepare detailed and accurate cost estimates for mechanical systems in construction projects. • Review project plans and specifications to determine the scope of work and required materials. • Collaborate with project teams to develop comprehensive cost management plans. • Analyze project requirements and provide value engineering options. • Perform cost risk analysis and provide input into value engineering. • Communicate and collaborate with clients, contractors, and other stakeholders. • Utilize industry-specific estimating software and tools to prepare estimates. • Provide estimating advice, guidance, and analysis to project stakeholders. • Maintain up-to-date knowledge of industry-specific estimating processes and methodologies. • Prepare formal estimating reports, including quantity, cost, escalation, and other assumptions and clarifications. • Assist in the development of estimating standards and best practices.

Missouri
$135K - $150K / year