Provider Systems Support Specialist (Finance)

We offer remote work opportunities (AK, AR, AZ, *CO, FL, *HI, IA, ID, *IL, KS, LA, MD, *MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

Provides systems and transactional support and education to providers via phone and email. This position will function as a resource to providers with questions related to the CareAffiliate and Availity system. This position is proficient at handling all provider systems inquiries. This role requires the ability to interface with providers regularly, ensuring they are informed and empowered to use the platform effectively.

Education & Experience

Required:

• H.S. Diploma or G.E.D.
• U.S. Citizenship
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 2+ years of experience in a high-volume customer service, medical office or contact center environment
• Technology literate and experienced in navigating multiple screens or web browsers at one time and proven ability to work independently in a remote work environment

Preferred:

• Bachelor's degree in Business, Health Care Administration, or related field
• Health care or provider systems application support experience

Key Responsibilities

• Monitor and triage inbound support requests, ensuring prompt and accurate responses.
• Conducts outbound calls to providers dealing with navigation issues, applying in-depth knowledge of Availity and CareAffiliate solutions, processes, and procedures.
• Interface with providers to understand and resolve issues, offering clear, step-by-step guidance.
• Perform root cause analysis using TriWest internal reports, to provider data challenges and communication with cross-functional teams for escalation.
• Use de-escalation techniques when necessary to ensure a positive provider experience.
• Maintain accurate documentation of interactions to inform future support strategies.
• Stay updated on platform features and product changes to provide accurate support.
• Ensures calls and issues are identified, tracked, reported on and resolved in a timely manner.
• Maintains comprehensive tracking and documentation for all identified issues to completion.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation.

Communication / People Skills: Excellent communication skills to explain complex issues clearly; ability to de-escalate situations and deliver excellent customer service under pressure.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Information Management: Ability to manage large amounts of complex information easily, communicate it clearly, and draw sound conclusions.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Proficient data entry skills; ability to resolve problems involving more complex concepts, policies, and procedures.

Working Conditions

Working Conditions:

• Ability to cover any work shift 6:00 a.m. - 9:00 p.m. PST M-F, with no travel
• Works within a standard office environment
• Extensive computer work with prolonged sitting and wearing of headset

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Generous paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Illinois, Minnesota, Washington D.C. and Washington State residents: $40,000-$51,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.