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Pearl Interactive Network, Inc. is a fast growing managed services and national staffing firm. In addition to performing a social mission of creating jobs for veterans, disabled veterans, people with disabilities, military spouses and people living in geographically challenged areas, we provide exceptional service to all job-seekers.  We believe that it is our duty to be an asset to our customers, to each other and to the community. We are honored that you have decided to pursue an employment opportunities with us.

As an equal employment opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

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Bilingual Provider Support Specialist-Remote

Location: Killeen, TX

Pearl Interactive Network is seeking a Bilingual (English and Spanish) Provider Support Specialist II for a Provider Service Center.  The Provider Support Specialist II is responsible for providing a broad range of customer and provider experience lifecycle management support services. This includes but not limited to bi-directional provider support services; tracking of provider interactions; ticket support; providing technical direction and oversight; reporting, data sharing; and improving business workflow and processes for the PRF in alignment with HRSA’s strategic goals and objectives.

Job Duties:

  • Receive approximately 5000 provider inquiries per month from designated frontline staff involved in HRSA’s PRF, as needed.
  • Check provider status within a reporting or application system, as needed.
  • Analyze PRF information to draft general responses to incoming questions, as needed.
  • Respond to provider inquiries using a unified platform for effortless digital customer service such as Salesforce for customer relationship management, as needed.
  • Conduct outreach surveys to maintain a high level of provider service and satisfaction through good communication and relationships with providers, as needed.
  • Handle approximately 35 percent of calls from providers with concerns, disputes, or may requests to speak with a supervisor about their case, as needed.
  • Rapidly respond to provider inquiries with the accurate information and anticipating customer needs as the PRF evolves.
  • Proactively track provider interactions from beginning to end to improve case management workflow and provider engagement.
  • Perform content and knowledge management, relationship management, and customer satisfaction surveys that empowers staff to resolve problems and create a lasting impact on the customer experience.
  • Respond to complicated policy or technical issues, or complicated compliance issues, as needed.
  • Respond to payment-related inquiries on returns, as needed.
  • Respond to partial payments, and payment adjustments.
  • Performing potential future recoupment activities, audit support.
  • Perform fraud risk management activities.
  • Verify/update provider information; and gathering and organizing missing information on different provider types.
  • Respond to a variety of general and specific provider inquiries, including receipts of incoming calls on complex inquiries. forwarded from HRSA’s frontline staff. The call volume is highly variable based on future PRF activities.
  • Perform a host of pre- and post-payment activities with varying complexities. Theses inquiries shall be on a multitude of topics including but not limited to application status, eligibility inquiry, attestation inquiry/issue, pre-/post-payment status/disputes, check related inquiry, check payment received/provider will not cash, underpayment, overpayment, returning funds, revenue submission malfunction, payment integrity related inquiry, other general inquiries.
  • Reach out to providers with suspected abuse to validate their authenticity.
  • Collect data from providers as it relates to targeted distributions and the PRF reporting requirements (e.g., hot spots).
  • Conduct surveys on providers to better understand their experience.
  • Respond to provider inquiries regarding technical polices from providers with greater than $10K payment.
  • Respond, investigate, and resolve inquiries regarding discrepancies, and partial returns, and underpayments
  • Respond to inquiries related to audits and recoupment based on current data mismatch on attestation and providers who kept funds and called in discrepancies.
  • Maintain a current understanding of the Program’s standard operating procedures, processes and Program policies as provided during training.
  • Attention to detail while processing, being especially mindful of PII exposure.
  • Adhere to and support service level metrics that includes schedule adherence, average handle time, response accuracy and quality metrics.
  • Utilize standard technology such as telephone, e-mail, and screen sharing to perform job duties.
  • Perform other duties as assigned.

Classification:  Full-time, Non-exempt

Operating Hours:  9am - 9pm EST, Mon. - Fri.

Preferred Location:  Virtual based, Killeen, TX (Bell County)

Requirements:

  • High school diploma, GED, or equivalent education required
  • Must be Bilingual (English and Spanish)
  • Minimum three (3) year customer service and/or financial products for service experience required
  • Ability to speak, read and write in English and professionally required, bilingual (Spanish) preferred
  • Favorable Fitness Determination required; subsequent to government background checks, including eQuip and NACI background check
  • Participate in training and receive certification that all required modules received a passing score.
  • General knowledge of government programs
  • Ability to receive inquiries from the hearing, speech, and visibly impaired, as well as other physically impaired callers
  • Familiarity with CRC or CRM contractor computer systems
  • Must be able to type a minimum of 20 WPM, 30 WPM preferred
  • Ability to effectively work within established contractual turnaround times required

 

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. Pearl management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

Background/Suitability Check, Drug Screening and Skills Assessments Required

Skills/Qualifications/Keywords: Action Oriented/Tenacity, Dealing with Ambiguity, Compassion, Customer Focus, Ethics and Values, Functional and Technical Skills, Informing, Integrity and Trust, Listening, Priority Setting, Problem Solving, MS Outlook and Office Skills, Leadership Team, People Skills, Diversity, Professionalism, Organization, Team Oriented, Learning, Flexibility, Effective Communication.

Pearl offers a full benefits package that includes medical, dental, vision, life insurance, paid time off, paid holidays, and a 401K. Additional ancillary benefits will also be available.

Pearl Interactive Network, Inc. is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, veteran status, disability status, genetics, or sexual orientation and gender identity.

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