Provider Operations Co-ordinator

VitalityHealth is an award winning, dynamic and vibrant health insurance provider, with a ground-breaking vision for the future, where individuals are enabled to succeed and are rewarded and recognised for their contribution to our business.

Our CORE PURPOSE is to make people healthier and to enhance and protect their lives. From people to products and processes, we aspire to deliver on our purpose in everything we do.

Our VISION is to be the BEST health insurer in the UK. We are looking for talented individuals who are committed to living our values and delivering an award winning service to our customers.

Job Purpose

To provide a professional, efficient, courteous and accurate front line telephone/claims and administration service to all Healthcare Providers. To develop a high level of technical expertise across all areas of the business and be an expert in Customer Service, including first point of contact resolution.

To assist the Clinical Operations team with the implementation of the consultant management strategy, effectively managing professional costs to ensure VitalityHealth members have access to high quality, affordable healthcare.

The role will include building positive relationships with Healthcare Providers, investigating the processing of invoices and understanding the results, specialist fee management, negotiation initiatives, provider recognition and provider related complaints.

The post holder will work effectively with a variety of teams and stakeholders across the Clinical Operations area and wider business.

Dimensions

Reports to the Provider Services Team Manager

The job holder works with other team members.

First point of contact for all Healthcare Provider queries.

Jobholder will have good negotiation skills.

Jobholder requires the ability to understand processes across all areas of the business.

Jobholder may be expected to undertake limited travel (Stockport/Bournemouth/London).

Jobholder will maintain skills and knowledge relevant to work area.

Key Outputs

Provide a professional standard of Customer Service

Maintain complete and accurate records of all customer queries

To achieve set targets for productivity and quality

To assist Healthcare Providers by addressing queries direct or escalating to an appropriate member of the Provider Services team.

Undertake administrative tasks as necessary to maintain the smooth running of the department

To assist in the management of Customer (specialist, and policyholder) complaints.

To co-operate in the promotion and implementation of EDI billing and BAC’s payments with all Healthcare Providers.

To act as the alternative point of contact for providers relating to all recognition of Healthcare Providers, and ensure issues raised are resolved

To assist in the registration of new Healthcare Providers, in accordance with company recognition criteria.

Retain business by ensuring positive messages and commercial considerations are always considered

Relay customer feedback, process issues and areas for improvement

To assist in providing information such as newsletters, mail shots and information guides, to providers.

To actively contribute towards the overall development of the team and department.

To contribute to project work as required.

Carry out audits and provide resulting feedback

Regulatory Responsibilities

You are required to understand and comply with all relevant rules, regulation and legislation applicable to your role. This means:
Acting with integrity and due skill, care and diligence at all times.

Ensuring that customers are treated fairly at all times

Ensuring that communications via any medium meet the principle of 'clear, fair and not misleading'

Undertaking relevant internally arranged training on systems, processes and regulatory requirements relevant to your role

Identifying and escalating (through your line manager) risks that impact the business, customers or other third parties

Reporting (through your line manager) any issues and/or system/process failures that may impact on service to customers

Experience

Essential

Previous experience in a customer facing role

PC literate with good knowledge of Word and Excel.

Excellent verbal and written communication skills

Desirable

Private Medical Insurance business knowledge.

Skills and Attributes

Establishing good working relationships with fellow team members.

Flexible and quick to learn new skills

Ability to recognise opportunities for process improvement without compromising quality of work.

Understanding the company standards for recognition of Healthcare Providers.

Ensuring that Healthcare Providers satisfy recognition criteria and comply with fee schedules.

Develop and maintaining market awareness.

Reacting effectively to unforeseen challenges.

Dealing with difficult situations, maintaining a positive attitude and promoting the company.

Effectively communicating at all levels, balancing the needs of the individual with thos