In-House Network Representative
Centrum Health
Posted on 2/9/2023
Bright Health

1,001-5,000 employees

Affordable personalized health insurance
Company Overview
Bright Health's mission is to make healthcare right. They believe quality health insurance should be simple, personal, and affordable. So they design easy-to-understand plans with benefits you'll actually use. Benefit-packed plans and surprisingly low rates mean you can focus on staying happy and healthy.
Doral, FL, USA
Experience Level
Desired Skills
Customer Service
Customer Success & Support
  • Our mission is to make healthcare right. Together. We are a value-driven healthcare company committed to providing personalized care to aging and underserved populations. We do this by aligning stakeholders across the healthcare ecosystem. Together, we can improve consumer experience, optimize clinical outcomes, and reduce total cost of care
  • What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative
  • If you share our passion for changing healthcare so all people can live healthy, brighter lives - apply to join our team
  • A bachelor's degree in healthcare administration or equivalent
  • A minimum of 2 years experience in client services, provider relations, and claims processing
  • Knowledge and understanding of claims processes and data capturing
  • Proficiency in creating presentations, training documents, reports, and analytical graphs
  • Proficiency in MS Outlook, Excel, and Word
  • Ability to work independently
  • Excellent verbal and written communication skills
  • Good problem-solving skills
  • Must be bilingual (English & Spanish)
  • Initiating and maintaining effective channels of communication with service providers and clients
  • Gathering, reviewing, and verifying all pertinent information relating to participating healthcare providers
  • Establishing and maintaining relationships with assigned healthcare providers through office visits, telephone calls, prompt resolution of issues, and excellent customer service
  • Conducting training of service providers on policies, procedures, service lines, and available technology
  • Answering questions from doctors' offices on benefits
  • Gathering, reviewing, and submitting relevant documentation needed for claims processing
  • Managing healthcare provider accounts to achieve company strategies and goals
  • Maintaining a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare
  • Assisting help desk staff with more complicated benefit queries received
  • Identifying shortfalls in healthcare provision and initiating improvement opportunities