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North East Medical Services · 1 month ago

PROVIDER AND CLIENT SERVICES REPRESENTATIVE

Burlingame, CA

Full-time

Hybrid

Entry Level

1+ years exp

North East Medical Services is seeking a Provider and Client Services Representative to provide administrative support to the MSO Department and assist with inquiries related to MSO operations. The role involves handling communication with providers, vendors, and clients, as well as supporting value-based care improvement activities.

Hospital & Health Care

H1B Sponsor Likely

Responsibilities

Responsible to provide primary support to MSO Utilization Management, and Claims main phone line, general mailbox, voicemails, faxes, and other administrative tasks

Responsible to research and understand basic authorizations, claims, provider appeals, benefit coverage issues raised by physician practices and/or health plan partners, coordinate follow up activities for resolution

Responsible for coordinating investigation activities for member grievances; track progress and report results to contracted Health Plan(s) within required timeframe

Assist the Value Based Care Programs team with outreach phone calls and other patient care improvement activities

Thoroughly and efficiently respond to all emails and/or voicemails that require any action in a timely manner

Complete other administrative and clerical tasks as assigned

Performs other job duties as required by manager/supervisor

Qualification

Healthcare experienceCommunication skillsPC literacyManaged care knowledgeLanguage fluencyDetail-orientedProblem-solving skillsOrganizational skills

Required

Must have excellent communication skills (verbal and written), ability to communicate effectively with a variety of professionals, including physicians and other healthcare providers, business administrators and other healthcare services agencies

Must be PC literate - Strong Excel, Word, Power point, and Outlook skills

Detail-oriented and organized with the ability to interpret policy and make decisions

Good organization and problem-solving skills

Ability to self-manage and work with multiple departments within the organization and external clients

Must be able to fluently speak, read and write English

Preferred

BA/BS Degree is preferred

One-year experience working in healthcare setting is preferred

Knowledge of managed care and Medicare/Medi-Cal program is strongly preferred

Fluent in Chinese (Cantonese and/or Mandarin) preferred

Fluency in other languages is an asset

Benefits

Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children

Company contribution to 401(k)

Company

North East Medical Services

North East Medical Services (NEMS) is one of the largest community health centers in the United States targeting the medically underserved Asian population.

Founded in 1968

San Francisco, CA, US

501-1000 employees

https://www.nems.org/

H1B Sponsorship

North East Medical Services has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (20)

2024 (7)

2023 (8)

2022 (5)

2021 (1)

2020 (1)