Paradigm is the industry leader in solving complex health care challenges and improving lives for injured workers. For almost 30 years, weve set the standard for outcomes-focused care for workers compensation cases involving the most challenging catastrophic injuries.
With the most connected and experienced team in health care, Paradigm defines and delivers outcomes that exceed financial and health expectations for our clients, as well as for individuals and their families. With a mission to help as many people as possible, we work to restore an injured workers health, their spirit, and their hope for a brighter future.
At Paradigm, the ultimate measure of our success is whether we help an injured worker and their family live a better life. Thats because we know that when we focus on the patient, we deliver better value for our clients as well.
To establish relationships with providers to secure single-case agreements and permanent contracts at company approved jurisdictional margins.
RESPONSIBILITIES AND DUTIES
- Utilize proprietary company information/programs as well as non-company systems/programs to identify physician prospects.
- Gather and submit provider/physician demographics/web address and submit for entry into company programs.
- Utilize proprietary company programs/tools to identify optimal reimbursement range.
- Calls physician prospects to explain company services and solicit/negotiate with them to accept referral via single case agreements with option for further referrals deploying tactful negotiation skills.
- Prepare single patient contract and submit to physician/provider.
- Schedule initial appointment as needed.
- Follow up with provider to ensure single case agreement has been signed and returned.
- Follow up with provider regarding full participation.
- Prepare, submit, negotiate and secure participation agreement as applicable.
- Update proprietary programs daily- documenting efforts.
- Act as a resource to answer any general provider contracting questions.
- Perform data-analysis as requested by management.
- Assist management in training new associates.
- Perform additional duties as identified and directed by management.
- College degree preferred. High school diploma or equivalent acceptable with commensurate experience.
- Exceptional communication and telephone skills required, as well as a great deal of patience, understanding and tact.
- Possess a high level of self-confidence and persistence; maintain an assertive approach in dealing with providers.
- Must possess excellent organizational skills and ability to multi-task effectively.
- Demonstrate the ability to prioritize heavy workload independently with minimal supervision.
- Proficient computer and internet skills; familiarity with Microsoft applications required.
- Will develop in-depth knowledge of department and company internal workflows, including but not limited to individual jurisdictional statutes, procedures and negotiating protocols.
- Call center experience a plus.
- Bilingual (English/Spanish) a plus.