Vālenz Health®
About Our Opportunity
As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—and at Valenz we call it customer love. Things You’ll Do Here
Facilitate inquiries from providers regarding reimbursement rates. Negotiate ongoing and single case agreements (SCAs).
Direct members to in‑network or RBP accepting providers.
Focus on the member journey and minimize disruption to providers.
Develop trust with members and providers to ensure long‑term relationships.
Anticipate and identify issues and escape to the appropriate manager or team leader.
Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn‑around‑times, and success rates.
Facilitate the appeals process.
Maintain compliance with company policies and procedures.
Perform related duties as assigned by supervisor. What You’ll Bring to the Team
1+ years of experience in customer service.
Experience working independently and completing assignments within given instructions, routines, and accepted practices.
Excellent verbal and written communication skills.
Ability to work in a fast‑paced, customer focused, and deadline‑driven environment.
A Plus If You Have
Experience working in a healthcare environment with providers. Where You’ll Work
Work Environment: You’ll need a quiet workspace that is free from distractions.
Technology: Reliable internet connection—if you can use streaming services, you’re good to go.
Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company‑approved devices/software.
Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. Benefits
Generously subsidized company‑sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
Spending account options: HSA, FSA, and DCFSA.
401K with company match and immediate vesting.
Flexible working environment.
Generous Paid Time Off to include vacation, sick leave, and paid holidays.
Employee Assistance Program that includes professional counseling, referrals, and additional services.
Paid maternity and paternity leave.
Pet insurance.
Employee discounts on phone plans, car rentals and computers.
Community giveback opportunities, including paid time off for philanthropic endeavors. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics. Powered by JazzHR
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As a Provider Relations Representative, you will educate providers and members about specific plan designs while also addressing their inquiries related to reimbursement, appeals, and network access. To be successful in this role, you will have a passion for customer care—and at Valenz we call it customer love. Things You’ll Do Here
Facilitate inquiries from providers regarding reimbursement rates. Negotiate ongoing and single case agreements (SCAs).
Direct members to in‑network or RBP accepting providers.
Focus on the member journey and minimize disruption to providers.
Develop trust with members and providers to ensure long‑term relationships.
Anticipate and identify issues and escape to the appropriate manager or team leader.
Ensure that the best possible solutions are offered by adhering to established rules regarding client rate structures, turn‑around‑times, and success rates.
Facilitate the appeals process.
Maintain compliance with company policies and procedures.
Perform related duties as assigned by supervisor. What You’ll Bring to the Team
1+ years of experience in customer service.
Experience working independently and completing assignments within given instructions, routines, and accepted practices.
Excellent verbal and written communication skills.
Ability to work in a fast‑paced, customer focused, and deadline‑driven environment.
A Plus If You Have
Experience working in a healthcare environment with providers. Where You’ll Work
Work Environment: You’ll need a quiet workspace that is free from distractions.
Technology: Reliable internet connection—if you can use streaming services, you’re good to go.
Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company‑approved devices/software.
Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA. Benefits
Generously subsidized company‑sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
Spending account options: HSA, FSA, and DCFSA.
401K with company match and immediate vesting.
Flexible working environment.
Generous Paid Time Off to include vacation, sick leave, and paid holidays.
Employee Assistance Program that includes professional counseling, referrals, and additional services.
Paid maternity and paternity leave.
Pet insurance.
Employee discounts on phone plans, car rentals and computers.
Community giveback opportunities, including paid time off for philanthropic endeavors. Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties. At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics. Powered by JazzHR
#J-18808-Ljbffr