Description

American Specialty Health Incorporated is seeking a Practitioner Validation Rep I to join our Provider Relations (PRL) department. This position will make outbound calls to contracted practitioners to perform their required quarterly directory validation. Educate practitioners regarding the validation requirements and assist the practitioner in completing the validation process, while maintaining a high degree of professionalism and providing excellent customer service.

Remote Worker Considerations

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment. This remote/WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum internet download of 50 Mbps and 10 Mbps upload speed).  

Responsibilities

• Outreach and educate contracted practitioners to ensure compliance is met.
• Outreach to practitioner network of practitioners who have not validated their demographics in order to meet regulatory requirements.
• Instruct practitioners on the directory validation process within the ASH practitioner portal – ASHLink.
• Outreach to list of practitioners to audit and confirm current directory listing information for accuracy in support of State, Federal, accreditation, and health plan requirements.
• Handles complex requests that require research to achieve appropriate resolution.
• Captures practitioner change information, documents and forwards as required to record changes in appropriate databases.
• Handles necessary administrative duties to properly support, document and resolve practitioner inquires.
• Maintains confidentiality of practitioner files, participation data, practitioner records/documents and all discussions relative to recruiting, contracting, and credentialing processes.
• Attends department and all-staff meetings to increase knowledge and foster teamwork.

Qualifications

• Associate’s degree preferred. High school diploma required.
• Minimum two years of progressive experience performing customer service duties.
• Specialty health care or health care experience preferred.
• Proficient in MS Office with experience in word processing and spreadsheet applications.
• Strong verbal and written communication skills.

Core Competencies

• Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
• Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
• Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
• Ability to effectively organize, prioritize, multi-task and manage time.
• Demonstrated accuracy and productivity in a changing environment with constant interruptions.
• Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
• Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.
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