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Hybrid Provider Service Representative. -Prior Authorization

AlpinePhysicians · USA, Colorado, Denver, United States Of America · Hybrid

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Job Description:

Provider Representative (Call Center Representative)

We are looking for a highly organized and compassionate Provider Representative (Call Center Representative) to join our clinical call center team. In this role, you will provide exceptional customer service and administrative support to patients, healthcare professionals, and external stakeholders. Your primary responsibility will be managing incoming calls and facilitating communication between patients and medical staff. The ideal candidate should have strong communication skills, attention to detail, and the ability to handle high call volumes with professionalism and empathy. This position requires commitment to our organization's core values, demonstrating discretion, diplomacy, and professionalism in all patient and staff interactions.

Schedule & Work Environment

Hours: Monday – Friday, 8:30 AM to 5:00 PM (30-minute lunch break)

Remote Work: After 1 week of onsite training in Denver, CO

Responsibilities

Answer incoming calls during scheduled working hours, ensuring timely and professional communication with patients, providers, and external stakeholders

Contact providers directly for critical matters

Support providers in the field with patient care-related tasks

Assist with Chronic Care Management (CCM) and other administrative duties, including:

Processing medication prior authorizations

Managing referrals placed by providers in the field

Scanning and uploading documents to patient charts

Reviewing, scanning, and approving home health and hospice orders

Reviewing and consulting providers on lab/diagnostic results

Processing prescription refills

Handling critical reports and managing fax inboxes

Checking voicemails for non-urgent messages

Completing medical records requests

Managing new admission and discharge summaries (Corhio, EPIC, Kaiser)

PDMP record pulling

Assisting with documentation related to patient care, such as DME requests and long-term care paperwork

Qualifications

Experience with electronic medical records (EMR)

Proficiency in medical terminology

Experience with medication prior authorizations and medication reconciliation (preferred)

Excellent communication skills for patient interactions and documentation

Strong computer and phone skills

Ability to multi-task and work effectively in a fast-paced, high-stress environment

Ability to work flexibly and cross-train within other departments as needed

Reliable high-speed internet connection (WiFi is not sufficient)

Understanding of HIPAA confidentiality standards

Valid Colorado Driver’s License & insurance (as needed for duties)

Education & Experience

High School Diploma or GED (Required)

Medical Certification or Health Technician training (Preferred)

Salary

$21 - $22/hour

If you thrive in a dynamic, fast-paced environment and enjoy working with a team of dedicated professionals, we’d love to have you join us!

Salary Range:

$21-$22 hourly

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!