Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. And while we may be a little biased, we believe that our work shapes communities and changes lives.
We have big hearts and love big ideas. We’ve been around for more than 100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways. We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence.
What you’ll do:
Works collaboratively with the External Provider Relations Specialist (EPRS) and the Healthcare Contract Specialist as an internal liaison to market, service, and educate the provider healthcare network. Supports both the provider and vendor contracting functions executed within the PNM department in an effort to meet the contracting and relationship needs and maintenance of the provider network.
What you can expect:
- Provide exceptional telephonic customer service per the Provider Network Management (PNM) customer service ACD phone line. Answers call promptly and accurately, meeting team performance and quality metrics.
- Provide exceptional customer service per the Provider Management email. Respond to emails promptly and accurately.
- Effectively resolve provider issues in a timely manner per team metrics.
- Develop and maintain positive provider, clinic staff, and internal customer relationships via the phone per Internal Provider Relations Specialist (IPRS) Satisfaction Survey results.
- Consistently and accurately document all provider interactions in CRM tool immediately following telephone or email exchanges.
- Maintain and ensure strict confidentiality of provider-specific information and files.
- Manage all provider demographic information changes (tax identification numbers, new address, email, contact information, phone, etc.) in a timely manner.
- With guidance from the Contract Specialist, administratively manage new contracts from beginning to end
- Ensure all required contract documents and information are requested, received, and validated for the vendor file according to timeliness metrics.
- Maintain Salesforce tracking system for contracts and related documents/correspondence.
- Manage the maintenance of provider and vendor electronic contract files, ensuring accuracy and integrity.
- Consistently and accurately add online contract interest forms to CRM tool and create draft contract files to be used by the Healthcare Contract Specialist
- Audit contract file and components within 3 days of receipt of checklist.
- Manage and update the online provider directory promptly once notified of a change or inaccuracy.
- Identify and provide feedback to EPRS regarding network trends (overutilization, clinical outcome data, and Provider Feedback Loops).
- Provide internal customer support for EPRS and for all Pinnacol teams.
- Maintain and distribute network “cheat sheets” for use by internal customers (customer service, medical case management, claims representatives, etc.)
- Contribute to Pinnacol Strategic Priorities through team initiatives.
Additional Duties:
- Provide first-line coverage for the Network Educator and second-line coverage for the Provider Network Operations Coordinator, Credentialing Coordinator, and Physician Advisor Program
- Provide support for medical payments queue requests and updates to vendor records in accordance with established departmental metrics.
- May assist other MOHS staff on service/educational visits as determined by manager
- Assist with provider communication including emails, mailings, and phone calls
- Assist with PNM network audits as needed
- Assume lead position for special projects as assigned by manager
- Perform other duties as assigned to meet business needs.
What you need to be successful:
- Bachelor’s Degree strongly preferred or equivalent experience on a year-for-year basis in business, health care, insurance, or a related field. A combination of professional and technical education and experience providing the same type and amount of knowledge on a year-for-year basis may also be considered.
- Minimum of three years of insurance or managed care customer service experience, preferably in the Workers’ Compensation arena. Some of this experience should be related to collaborating and working directly with physicians and medical staff and facilities.
- Polished professional with the ability to communicate (oral and written) effectively with professionals at all levels inside and outside of the organization.
- Knowledge and application of English grammar including composition, editing, and proofreading skills.
- Proficient with Google Workspace and MS Office
- Salesforce knowledge and proficiency are preferred.
- Ability to produce accurate and precise work; detect and resolve discrepancies, and meet deadlines.
- Ability to effectively work independently and effectively participate as part of a team.
- Strong organizational, time management, and project management skills with multi-tasking abilities.
- Strong information documentation expertise
- Strong analytic and problem solving abilities
- Strong understanding of medical terminology
Competencies:
- Attention to detail: Working in a conscientious, consistent and thorough manner.
- Client focus: Providing service excellence to internal and/or external clients and stakeholders.
- Initiative: Dealing with situations and issues proactively and persistently, seizing opportunities that arise.
- Legislation, policies, procedures, and standards: Understanding and using relevant legislation, policies, procedures and/or standards in performing one's work.
- Relationship building: Establishing, sustaining and fostering professional contacts to build, enhance and connect networks for work purposes.
- Results Management: Organizes time, work and resources to accomplish objectives in the most effective and efficient way.
- Strategic thinking: Understands and processes complex information and exercises sound judgment, considering the situation, the issues, the key players, and levels of authority involved. Proposes course of action that further the objectives, priorities and vision of organization.
We can’t do our work without people like you.
Our employees are extraordinary and committed to making a difference. Here’s some of the ways we show our appreciation.
- Our benefits go beyond the basics. You’ll get to choose from diverse benefit offerings for medical, dental and vision.
- We care about each other. We enjoy a positive, collaborative work environment. We are hard workers and high performers.
- We love who you are. Pinnacol is on a journey to embody diversity, equity and inclusion. We’re committed to creating a culture that deeply values differences, where everyone feels like they belong.
- Take a day (or 20!) off. Enjoy 20 paid days off your first full year plus 9 paid holidays.
- Take care of yourself. Sign up for unique wellness programs, including on-site, company-paid fitness facilities and classes
- Get your learning on. We promote a learning culture to help you master your current job and cultivate the skills of the future through a variety of on-site, online, and off-site professional development opportunities.
- Give back and get paid. Through our employee volunteer program, Pinnacol in Action, employees receive paid time off to volunteer with Colorado nonprofits.
- Share in our success. You’ll have the opportunity to earn a quarterly incentive, up to 12 percent of your annual base salary, when your team exceeds their goals and objectives.
When we find the right person, we try to put our best foot forward with an offer that excites you. We consider what you’d like to be paid, the skills and experience you bring, what similar jobs pay in the Denver area and make sure there’s equal pay for equal work among those you’ll be working with. The compensation amount for this role is targeted at $72,650 - $81,300. Final offer amounts are determined by multiple factors including your experience and expertise and may vary from the amounts listed above.
Want to love your work? Apply today!
Pinnacol is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email recruiting_team@pinnacol.com.
This posting will close 14 days after being published; August 26, 2024
Salary Range
$72,650—$81,300 USD
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Last updated on Aug 12, 2024