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Provider Relations-Networking-Contracting WellCare - Provider Administration & Support Careers

Provider Operations Clerk Job

Full Job Title: Provider Operations Clerk

Job Number: 1802432

Location: Newark, NJ

Date Posted: 4-6-2018

Responds to provider inquiries regarding eligibility and benefit verification in a professional, timely, accurate manner while consistently meeting all guidelines.

Essential Functions:
  • Responds to provider inquires via telephone while meeting all corporate guidelines and performance standards.
  • Provides eligibility and benefit information to providers.
  • Identifies & researches all member/provider eligibility issues initiated by the provider.
  • Forwards enrollment discrepancies to the Enrollment Department for follow up and resolution.
  • Handles eligibility fax inquiries per department standards.
  • Records and forwards provider complaints/grievances to applicable departments.
  • Educates providers telephonically on how to administer online eligibility verifications via the website.
  • Demonstrates appropriate customer care skills such as active listening, courtesy, politeness, helpfulness and other skills as identified.
  • Performs other duties as assigned.
Additional Responsibilities:Candidate Education:
  • Required A High School or GED
Candidate Experience:
  • Preferred 6 months of experience in a Call Center environment
  • Preferred Other Previous experience in the Health Care Industry
Candidate Skills:
  • Beginner Other Written communication skills
  • Intermediate Other Verbal communication skills
  • Beginner Other Organization skills
  • Intermediate Other Time management and prioritization skills
  • Beginner Ability to effectively present information and respond to questions from families, members, and providers
Licenses and Certifications:
  • Preferred Other Customer Service, quality or training certification
Technical Skills:
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Word

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Last Updated On: 12/9/2015