Provider Engagement Associate

Summary

Join Clover Health as a Provider Engagement Associate and contribute to our mission of reinventing health insurance by focusing on keeping people healthier. You will facilitate smooth interactions between providers and Clover, ensuring prompt issue resolution and supporting initiatives to improve provider satisfaction and patient outcomes. This role blends technical skills, operational knowledge, and strong interpersonal abilities to optimize provider relationships and efficiently resolve complex issues. We are seeking candidates located in the Central and Eastern time zones of the United States. Success in this role involves accurate data entry, report generation, provider claims analysis, escalation resolution, and collaboration with internal teams. Long-term success includes building strong provider relationships, efficient project management, and applying problem-solving skills. The position offers a competitive salary, equity opportunities, and a comprehensive benefits package.

Requirements

• Be based in the Central or Eastern time zone of the United States
• Have a passion for healthcare, with 3+ years of experience in health insurance or medical offices
• Have a knack for coding
• Be comfortable with a variety of data tools
• Be detail-oriented and thrive on meeting deadlines
• Be a natural collaborator, excited to work with teams across the organization and beyond
• Be ready to bring skills and experience to a dynamic, evolving industry

Responsibilities

• Gain in-depth knowledge of Clover Health's operational processes, including Contracts, Claims Processing, Payments, Payment Integrity Audits, Configuration, and Grievances
• Serve as the main contact for high-priority providers and maintain positive on-going relationships, leading external meetings regularly
• Manage internal projects to enhance the provider experience, such as provider education on best practices and new policies
• Ensure timely investigation and resolution of escalated provider issues or inquiries, both internally and externally
• Work with internal and external teams to research and resolve provider escalations
• Identify and implement opportunities to reduce provider abrasion through root cause analysis and collaboration with management
• Utilize Excel; Pivot Tables, Formatting, Formulas, and Vlookups

Preferred Qualifications

Be a Certified Professional Coder

Benefits

• Competitive base salary and equity opportunities
• Performance-based bonus program
• 401k matching
• Regular compensation reviews
• Comprehensive medical, dental, and vision coverage
• No-Meeting Fridays
• Monthly company holidays
• Access to mental health resources
• Generous flexible time-off policy
• Remote-first culture
• Learning programs
• Mentorship
• Professional development funding
• Regular performance feedback and reviews
• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
• Reimbursement for office setup expenses
• Monthly cell phone & internet stipend
• Paid parental leave for all new parents