Provider Services Specialist

LegalEASE

Provider Services Specialist

Houston, TX
Full Time
Paid
  • Responsibilities

    Benefits:

    401(k)

    401(k) matching

    Competitive salary

    Dental insurance

    Health insurance

    Paid time off

    Vision insurance

    We are a legal access employee benefits company that makes the needs of members a priority and strives to offer them the best product and service in a personal, but professional, manner.

    At LegalEASE, we consider our culture to be among our most important resources. Over the decades our team members have built our culture into what it is today — an environment for our team members to be creative and grow, have fun and be successful, and help our customers to the best of their abilities. Today, this culture is the core at our decision making and strategy.

    Join our Team:

    We create a customer focused work environment by providing Team Members with the same level of service, respect, and dignity that we provide to our members. Our deeply instilled culture is personified by our Team Members who ensure that we have helped each and every member to the best of our abilities, and to become a company that is easy to work with. If you want to be a part of this cohesive team with opportunities to build a successful career, LegalEASE is the right place for you.

    Job Purpose:

    We are looking for a detail oriented, efficient individual who can derive a sense of pride and fulfilment in work well done. This role is a customer service position with the purpose of working with members to successfully obtain all pertinent information to have them matched with the appropriate legal representation. This role works in a call center environment handling inbound and outbound calls from and to members and providers. This role works in a team environment and is expected to consistently maintain metrics/KPI’s as defined by management.

    What you will do:

    Analyze Case Profile

    Contact Member Specialist or Manager for any additional information

    Search for a Provider using the CMS search function and proper procedures

    Confirm Provider is properly credentialed and approved

    Makes phone calls to Providers for case matching; All actions and information concerning matching must be documented within the case

    A minimum of five (5) match attempts must be made daily per case

    Confirmation of all matching points must be satisfied: distance, timeliness of referral, benefits, costs, area of practice, and member preferences/needs

    Send proper confirmations to Provider

    Send all proper documents to Provider (i.e. Questionnaire and Contract)

    Notate all applicable information into each case within the CMS

    Properly update the Attorney Database

    Communicate effectively and in a timely fashion with customers, teammates, and management

    Complete a Daily Status Updates when referrals are not ready the same day or the next day, so that the information can be communicated to the member

    Respond to all phone messages and emails within two (2) business hours

    Report daily activity, using the standard Daily Report format

    Assist with status updates, providing referrals, and making follow up calls as needed when call volume or staffing issues require

    You will do it using your:

    Excellent verbal and written communication skills.

    Ability to take ownership of project.

    Ability to meet aggressive deadlines while maintaining a positive attitude.

    Ability to work under pressure and follow through on tasks.

    Strong organizational skills, Ardent, with an applicable sense of urgency.

    High attention to detail and proven ability to manage multiple, competing priorities simultaneously with minimum supervision.

    Ability to build relationships with leadership team/department heads

    Ability to maintain in-depth working knowledge of LegalEASE’s systems and processes.

    Basic Qualifications:

    High School Diploma, College Degree preferred

    Must demonstrate strong customer service skills, displaying sound judgement and decision-making

    Must manage customer expectations by resolving issues in a timely manner

    Must plan work appropriately and balance multiple priories

    Excellent communication skills, both written and verbal

    Must maintain the highest level of professionalism

    Microsoft Office proficiency

    Our Offering:

    Culture built on Trust, Respect, and Integrity

    Environment that supports the personal drive for excellence

    Access to robust health insurance and legal benefit plans

    Training and Development opportunities

    Paid vacation

    Free Fitness Center on property

    401 (k) Retirement plan

    Work Authorization/Security Clearance:

    Candidate must have valid work authorization for the U.S.

    A criminal background investigation is conducted on every Legal Access Plans employee.

    All job requirements are subject to possible modification to reasonably accommodate individuals with disabilities. Some requirements may exclude individuals who pose a direct threat or significant risk to the health and safety of themselves or other employees.

    AAP/EEO Statement:

    Legal Access Plans is an equal opportunity employer.