Provider Engagement Associate
New
C
Clover HealthHealth Insurance
Remote - USA, Central and Eastern time zonesFull-TimeMiddle
Salary$63,800 — $83,000 USD
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Job Details
- Experience
- 3+ years
- Required Skills
- Data AnalysisSalesforceJiraMicrosoft Excel
Requirements
- 3+ years of experience in health insurance or medical offices.
- Strong proficiency in Microsoft Excel, including Pivot Tables, Formatting, Formulas, and Vlookups.
- Experience with Salesforce, JIRA, Mode, or Google Suite.
- Familiarity with industry-specific platforms such as Engagement Plus, SDS, iNetwork, Optum Pay Financial, or Health Rules Payor.
- Ability to manage complex provider escalations and maintain documentation with high attention to detail.
- Strong interpersonal skills for building and maintaining provider relationships.
- Reside within the Central or Eastern time zones of the United States.
- Certified Professional Coder (CPC) certification is a plus.
- Ability to travel occasionally for onsite meetings, provider visits, and training.
Responsibilities
- Serve as the main contact for high-priority providers and maintain positive ongoing relationships by leading regular external meetings.
- Investigate and resolve escalated provider issues or inquiries, both internally and externally.
- Manage internal projects to improve the provider experience, including provider education on best practices and policies.
- Identify and implement opportunities to reduce provider abrasion through root cause analysis and collaboration.
- Perform accurate data entry, report generation, and provider claims analysis.
- Maintain the Provider Claims Escalation spreadsheet with precision.
- Collaborate with internal and external teams to research and resolve complex provider escalations.
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