Providence MCO Representative 2 in Beaverton, Oregon
Providence St. Joseph Health is calling a MCO Representative 2 to our location in Beaverton, OR.
We are seeking a MCO Representative 2 to act as a resource to program participants and monitors provider and payer compliance to workers’ compensation MCO rules and contract requirements. The MCO Representative II evaluates and coordinates medical treatment reviews to reduce the number of time loss days and to assure that a proactive medical approach associated with treating injured workers occurs.
This position also provides advanced problem solving through the dispute resolution process with a diverse client population. This position must maintain supportive interpersonal relationships with all clients and with team members and also contributes to the team’s planning and organization efforts. This position is responsible for providing all customer service needs, for updating all operations materials and overseeing the accuracy of all information utilized by MCO clients.
Performs all duties in a manner which promotes team concept and reflects the Providence mission and philosophy.
In this position you will have the following responsibilities:
Report directly to the MCO Program Manager.
Key relationships includes MCO clients, providers, injured workers and legal representatives, the Department of Consumer and Business Services, as well as internal departments which support our service delivery.
Relate to a very diverse client distribution.
Required qualifications for this position include:
College Degree or combination of college courses and relevant work experience.
2 years experience with computer software applications.
2 years claims adjusting experience in workers’ compensation field.
Demonstrated competency in medical terminology and medical claims management.
State of Oregon Claims Adjusting Certificate.
Valid unencumbered Driver's license.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
About the ministry you will serve.
Providence Home and Hospice Services provides quality, timely comprehensive medical care in the homes of patients and with facilities in Washington State’s King, Snohomish, Thurston, Mason and Lewis Counties. The wide-ranging care we provide includes the service of physicians, registered nurses, medical social workers, rehabilitation therapists, home health aides, and volunteers. The collaboration and teamwork that is demonstrated by these qualified individuals provides a comprehensive and caring medical experience for patients and their families.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Analytics/Business Intelligence
Req ID: 263932
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