What are the responsibilities and job description for the Network Services Associate position at Paradigm?
Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm's business : risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.
The Network Services Associate will handle data entry, analyze data sets, handle incoming Provider Calls and emails and process reconsiderations. It is imperative that the Network Services Associate possess exemplary customer service skills, have a demonstrated ability to work independently, and function effectively as a member of the Network Services team.
DUTIES AND RESPONSIBILITIES :
- Answer in-coming calls during business hours and reply to phone messages left overnight when the phones are not staffed
- Respond to email bill inquiries and disputes from providers, clients and internal customers. Treat all customers, internal and external, in a courteous and cooperative manner by providing exceptional customer service to internal and external customers
- Understand and comply with all HIPAA & SOC2 requirements necessary in working with designated PHI
- Document and update information in cases and D365 with high degree of accuracy.
- Must utilize critical thinking skills while handling billing issues.
- Assist with training with team members and new staff as needed
- Process reconsiderations per client specific procedures
- Perform additional duties as identified and directed by management
QUALIFICATION REQUIREMENTS :
Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We're striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
