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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 (i.e., Single Referral Agreements) for One Call’s referrals if we are unable to staff through One Call’s provider network
Works with contracted providers that request reimbursement outside of contracted rates in conjunction with the Provider Engagement & Contracting Teams
Effectively and timely locate an out-of-network provider that meets the operational needs of a specific referral
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 is clean, clear, and concise
Cleary communicates dates and other instructions with the service provider(s) for negotiated files
Confirms Start of Care for negotiated files
Meets the established team standards, including (but not limited to) quality standards and turnaround time requirements
Provides an outstanding experience to internal and external customers, where applicable
Able to support various levels of management on ad-hoc requests and perform other related duties as assigned
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: We are a remote-first company, and almost all positions receive the flexibility of working from home
Generous Time Off: Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off
Comprehensive Benefits Package: Including medical, dental, vision, and pet insurance
401(k) matching program
and company-paid life insurance and short and long-term disability coverage
Supportive Services: We offer a Colleague Assistance Program that provides free counseling and financial services, and our One Call Foundation, a non-profit arm of our company, provides colleagues financial assistance during times of unexpected hardships