Provider Outreach Specialist in Latham, NY at Beacon Health Options

Date Posted: 12/30/2019

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

The Provider Outreach Specialist will be responsible for negotiating Single Case Agreements (SCAs) for out-of-network providers and completing tasks related to this function.
The Provider Outreach Specialist must provide complete and accurate information on all inquiries and meet deadlines per established departmental policies. This individual works in several systems simultaneously, handling work queues in the provider, clinical and customer service applications. This individual must meet or exceed established productivity and quality standards. The Provider Outreach Specialist communicates with internal departments and providers via event, inquiry, and in written correspondence.

What does a typical day look like?

  • Initiate SCA requests by taking data from inquiry requests, resolving issues, and responding to questions regarding the request.
  • Conduct follow up protocols on SCA requests to conduct the proper provider/member checks, gather the appropriate provider documentation, negotiation rates if applicable, coordinate with the clinical team to authorize the treatment, execute the SCA and assist with provider data entry and rate loading.
  • Oversee the administration and tracking of all assigned SCAs and coordinate with other teams as needed to facilitate completion of requests.
  • Perform complete investigation and conduct the necessary follow through on all inquiries regarding SCA requests. This includes inquiries related to initial requests, exception requests and follow up requests.
  • Research and accurately respond to inquiries regarding the status of SCAs.
  • Monitor work queue to ensure cases are processed within expected turnaround times.
    Other duties as assigned.

What you Contribute?

Education: High School/ GED diploma.
Relevant Work Experience:

  • 2 years’ experience in insurance, medical, healthcare or related field required.
  • Professional demeanor, strong written and oral communication skills, strong computer skills, and the ability to learn Beacon’s internal systems.
  • Ability to learn quickly, work independently, make decisions and be resourceful.
  • Detail-oriented, analytical, highly organized and possessing problem-solving skills.
  • Ability to manage varying job pressures, and meet deadlines and handle multiple tasks simultaneously with minimal supervision.
  • Ability to work in a production environment and meet production and quality goals.
  • Ability to work with many levels of staff and management, including technical teams.
  • Computer literacy and experience with Microsoft office programs (Outlook, Word and Excel), and internet searches.
  • Knowledge working with fax machines, copiers and other office machines.
  • Computer literacy and experience with Microsoft office programs (Outlook, Word, Visio, and Excel) and Adobe PDF.
  • Knowledge working with fax machines, copiers and other office machines.

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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