<p style="text-align:left"><b>ABOUT PERFORMANT:</b></p><p style="text-align:inherit"></p><p style="text-align:left">At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission:<i> To</i> <i>offer innovative payment accuracy solutions that allow our clients to focus on what matter most – quality of care and healthier lives for all</i>.</p><p style="text-align:inherit"></p><p style="text-align:left">If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture – then Performant is the place for you!</p><p style="text-align:inherit"></p><p style="text-align:left"><b>ABOUT THE OPPORTUNITY:</b></p><p style="text-align:inherit"></p><h3></h3>Hiring Range: $21.50/Hour<p style="text-align:inherit"></p><h3></h3><p><b>Member Advocates</b> are the primary point of contact for health plan members. They are responsible for assisting with coordination and communication between patients and medical professionals (i.e. <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">physicians/nurses/case</span> managers/pharmacies) which may include lending assistance with benefit education, appointment scheduling, navigating <span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">referral/authorization</span> processes, cost-management, community resource connections, and assisting with pharmacy benefits.</p><p></p><p><b>Key Responsibilities to include</b>:</p><ul><li><p>Make outbound calls to members who have indicated perceived gaps in care</p></li><li><p>Take inbound calls, answer questions regarding the program, document communication</p></li><li><p>Provide benefit education to members (explain copays, coinsurance, deductibles, in and out of network benefits, and formularies)</p></li><li><p>Schedule follow up times for additional care coordination management and/or community resource connections</p></li><li><p>Develop professional working relationships with colleagues, healthcare providers and other contractors</p></li><li><p>Conduct critical due diligence follow-ups if additional research or action is required to resolve a call the member’s concern/complaint</p></li><li><p>Enter and update all contact and activity information into system e.g., a telephone call is made, recorded, and attached to the case file in the system</p></li><li><p>Notify management of: </p><ul><li><p>displeasure or escalated concerns with the program</p></li><li><p>legal action</p></li><li><p>government intervention</p></li><li><p>suggestions to improve or correct processes or documents</p></li></ul></li><li><p>Communicate with other staff/departments as necessary</p></li><li><p>Maintain a current knowledge of campaign regulations, policies and procedures</p></li><li><p>Maintain current knowledge of all contract requirements and objectives</p></li><li><p>Maintain HIPAA Certification</p></li><li><p>Perform miscellaneous duties as assigned in a highly professional manner</p></li></ul><p></p><p><b>Knowledge, Skills and Abilities Needed</b>:</p><ul><li><p>Excellent verbal and written communication skills</p></li><li><p>Skilled in data entry and knowledge of computers</p></li><li><p>Courteous, professional, and respectful attitude</p></li><li><p>Strong understanding of customer service policies and processes</p></li><li><p>Member customer service background</p></li><li><p>Flexibility to handle any non-standard situations that may arise</p></li><li><p>Must be able to multitask</p></li></ul><p></p><p><b>Required and Preferred Qualifications</b>:</p><ul><li><p>At least 4 years medical customer service</p></li><li><p>At least 1 year Medical claims processing and/or billing experience preferred.</p></li><li><p>High School diploma or equivalent is required</p></li></ul><p></p><p><b>WHAT WE OFFER:</b></p><p></p><p>Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview.</p><p></p><p><b><u>Physical Requirements & Additional Notices</u>:</b></p><p></p><p><b><span>If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required</span></b><span>. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location.</span></p><p></p><p>The following is a general summary of the physical demands and requirements of an <span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">Office/Clerical/Professional</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary.</p><p></p><ul><li><p>Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.</p></li><li><p>Regularly reads and comprehends information in electronic (computer) or paper form (written/printed).</p></li><li><p>Regularly sit/stand 8 or more hours per day.</p></li><li><p>Occasionally lift/carry/push/pull up to 10lbs.</p></li></ul><p></p><p>Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:</p><ul><li><p>Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all <span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span style="overflow-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">positions). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.</p></li><li><p>Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.</p></li><li><p>Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures.</p></li><li><p>Other requirements may apply.</p></li></ul><p></p><p><span>All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.</span></p><p></p><p>Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant’s Human Resources team to discuss further.</p><p></p><p>Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.</p><p></p><p><span><span>THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED</span></span></p>
