Job Description

ROLE OVERVIEW

The Provider Health Assistant (PHA) is responsible for delivering a differentiated, personalized and incredible service experience for our providers.  PHAs primarily answer inbound calls from provider offices regarding patient-related services such as verification of benefits, verification of eligibility, pre-certification, and other general physician-patient care support needs. The PHA will seek to understand the question or concern, effectively and efficiently providing first call resolution, while delivering an excellent and empathic service experience.  You’ll have the opportunity to provide a highly valuable service to our provider community by helping them navigate the health care system in support of their patients’ health care needs.

A DAY IN THE LIFE…

·        Answering calls in a high volume, fast paced environment, from providers regarding patient-related services such as verification of benefits, verification of eligibility, pre-certification and other general physician-patient care support needs;

• Seeking to understand the context behind the provider’s call by probing for information to understand the provider’s questions or support needs in order to ensure first call resolution;
• Navigating and engaging multiple systems, and pulling the puzzle pieces together to resolve provider questions, complex issues and requests;
• Offering guidance to providers regarding their patient’s eligibility, coverage, pre-certification denials and appeals processes;
•  Educating providers on how to reduce errors in pre-certification process due to lack of information, and educating them on how to most effectively support their patients in the appeals process;
• Navigating and providing input to policies, systems, methods, and procedures for the effective management of key business processes;
• Create a memorable experience with Accolade and creating stickiness in Accolade’s service and capabilities;
• Performing other relevant tasks, as needed

Qualifications

WHAT WE ARE LOOKING FOR…

• Excellent customer service skills; strong verbal and written communication
• Ability to respond empathically
• Experience resolving benefits and provider network questions in a fast paced, telephonic environment
• Ability to answer the unasked question providing first call resolution
• Ability to navigate multiple systems and multi-task
• Ability to de-escalate tense situations and turn them into productive, resolve-oriented conversations
• Ability to navigate basic math scenarios including percentages, premiums/payments and out of pocket expenses (deductibles/coinsurance/copays)
• Quick thinker; ability to be innovative in approach to solving problems
• Demonstrated ability to take initiative, act independent and show a willingness to learn

·        Demonstrated ability to work in a collaborative team environment and be flexible and adaptable

• 1+ years of customer service experience in an insurance setting (Health Plan preferably) dealing with provider-related issues as well as pre-certification, benefits and eligibility questions
• Available to work 40 hours a week between 8am and 8pm
• College Degree Preferred (not required)
• Bi-lingual preferred

Additional Information

WHAT IS IMPORTANT TO US Creating an enduring company that is hyper-focused on our culture and making a meaningful impact in the lives of our employees, members and customers. The secret to our success is: WE FIND JOY AND PURPOSE IN SERVING OTHERS Making a difference in our members’ and customers’ lives is what we do. Even when it’s hard, we do the right thing for the right reasons. WE ARE STRONG INDIVIDUALLY AND TOGETHER, WE’RE POWERFUL Trusting in our colleagues and embracing their different backgrounds and experiences enable us to solve tough problems in creative ways, having fun along the way. WE ROLL UP OUR SLEEVES AND GET STUFF DONE Results motivate us. And we aren't afraid of the hard work or tough decisions needed to get us there. WE’RE BOLDLY AND RELENTLESSLY REINVENTING HEALTHCARE We're curious and act big -- not afraid to knock down barriers or take calculated risks to change the world, one person at a time.

All your information will be kept confidential according to EEO guidelines.

COVID 19 

VACCINATION & OFFICE POLICY

At this time, Accolade’s offices are open to vaccinated employees only, subject to

limited exceptions, for the safety and wellbeing of our staff.

Most onboarding training is conducted in our offices, but virtual onboard trainings are occasionally conducted at our discretion.

People & Culture will ask your vaccination status in order to properly prepare

training classes and protocols, accordingly.