Provider Services Associate II

Saint Paul MN 55125 HSM

Job Description

This position is responsible for answering inbound calls and communicating appropriate information concerning telephonic inquiries for all business segments. The role is responsible for documenting the nature of the inquiry and specific resolution within various operating systems. The overall expectation of this role is to utilize analytical, problem solving abilities while providing outstanding customer support to internal/external customers and to appropriately resolve inquiries during their initial interaction with Magellan. Role also involves daily processing of medical claims and correspondence.
  • Answer and respond timely, courteously and accurately to provider phone calls and emails.
  • Problem-solve issues and communicate accurate responses.
  • Collects and documents all details of provider interaction (inquiry, comments and information) into the Magellan operating systems.
  • Professionally educates providers on Magellan's policies and procedures and how to effectively interact with Magellan to optimize the provider's experience. Respond to the provider's inquiry in the most efficient manner.
  • Process and import electronic claim batches to claim system.
  • Interacts with other functional departments (e.g., clinical, contracting, etc.) , as needed to develop optimal resolution for Provider and Magellan.
  • Daily requirements may include filing, faxing, copying, coding of documents, reviewing error reports, and providing back-up to other functional teams.

General Job Information


Provider Services Associate II



Job Family

Customer Service Group


United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date


Date Requisition Created


Work Experience

Customer Service, Healthcare


GED (Required), High School (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements


Minimum Requirements:

Education: Associates Degree.

Experience: 1-3 years. Job Specific: Customer Service, HealthCare .An equivalent combination of experience and education is acceptable.Education and/or experiences may run concurrent.

Knowledge, Skills, Abilities: 60 WPM.

Computer Skills: Must be a proficient typist and be able to maneuver through various systems while interacting with the provider on the telephone.

Other: Excellent organizational, verbal, written and typing skills required, with the ability to handle multiple tasks concurrently. Must be detail oriented and able to concisely document information. Demonstrated ability to use tact and diplomacy to diffuse conflict and enhance the provider s experience interacting with Magellan. Must demonstrate a desire to gain a broad-based knowledge of Magellan. Must be customer service oriented and a team player, especially when providing feedback to teammates. Must demonstrate professional call handling skills while under stress. Must submit to call monitoring for the purposes of training and quality improvement. Must submit to a proficiency exam (written and typing) and conduct a mock interaction with a provider.

Preferred Qualifications:

Education: Bachelor s degree (Psychology, Social Services or Health Administration) preferred.

Experience: Experience in Customer Service within a Health Care environment. Knowledge of Cute Live support software preferred.

Knowledge, Skills, Abilities: Responsible for meeting call handling requirements and daily telephone standards.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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