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The Negotiations Specialist will provide real-time support to Operations by locating out-of-network providers and/or addressing in-network providers requesting rates outside of their contract by negotiating single rate agreements or identifying in-network providers willing to accept the referral utilizing contracted rates. The Negotiations Specialist is a partner to the scheduling team, ensuring that One Call secures providers and confirms negotiated services are started timely.
Job Responsibility:
Conduct negotiations with out-of-network/network providers for prospective referrals utilizing established guidelines
Executes short-term agreements for One Call's referrals if unable to staff through One Call's provider network
Works with contracted providers that request reimbursement outside of contracted rates
Effectively and timely locate an out-of-network provider that meets operational needs
Effectively communicate the One Call value proposition to out-of-network providers
Submit interested or viable non-contracted providers to Provider Contracting for contracting opportunities
Acquires minimum provider qualification documents at completion of Single Referral Agreement
Submits Single Referral Agreement request to Provider Data Management
Ensures proper notation and documentation for each assigned task
Clearly communicates dates and other instructions with service provider(s)
Confirms Start of Care for negotiated files
Meets established team standards
Provides outstanding experience to internal and external customers
Able to support various levels of management on ad-hoc requests
Requirements:
Associate's degree, or 1-2 years experience instead of a degree
Financial acumen
Proficient in negotiating with the ability to calculate margins based on client & provider pricing
Good understanding of One Call products and services
General knowledge of the workers' compensation industry
General knowledge of negotiation principles
Excellent customer service competencies
Excellent verbal and written communication skills
Proficiency to operate independently on work that is often confidential
Computer navigation and operation skills
Demonstrates effective people skills and sensitivities when dealing with others
Able to work both independently and in a team environment
Communicates concisely and professionally
Able to understand, apply, and explain concepts
Able to handle projects commensurate with job expectations
Able to analyze and solve problems using learned techniques and tools
Requires human relations, negotiation, and documentation skills
Requires high attention to detail
Flexibility, versatility, and dependability
Able to work in an environment that aligns with the company's diversity, equity, inclusion, and belonging standards
Able to work both independently and in a team
Demonstrate our core values of Think Big, Go Fast, Deliver Awe, and Win Together
What we offer:
Remote work
8 company holidays and 2 personal days every year
Minimum of 18 days of paid time off
Medical insurance
Dental insurance
Vision insurance
Pet insurance
401(k) matching program
Company-paid life insurance
Short and long-term disability coverage
Colleague Assistance Program (free counseling and financial services)
One Call Foundation financial assistance during times of unexpected hardships