Employment
The PHP Advantage
Unless you have a serious sense of adventure to enter into our casual but cutting edge culture, you'd better exit now! A Company like no other lies ahead...
Physicians Health Plan offers a one of a kind working experience that continuously challenges those of us who are part of it. A unique blend of a caring family and top-notch professionals provide PHP with the talent to compete in the ever-changing managed care marketplace. We look at the issues and concerns of our customers as our issues and concerns. Our team of talented, energetic individuals has a passion for excellent customer service.
These service values extend into the community that PHP serves. Employees have the opportunity to actively support the community through company-sponsored participation in events such as United Way's Day of Caring, volunteering at Matthew 25, adopting Christmas families, working with students through Junior Achievement, and much more...
At PHP, we believe in celebrating individual and team achievements such as Years of Service Anniversaries and team project successes. The diverse experiences and expertise of each PHP team member is an advantage over our competition and gives us reason to celebrate!
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PHP Receives National Honor
The Association for Worksite Health Promotion awarded PHP the 1999 Business and Industry Award for a Corporate-Based Program with less than 1,000 employees. This prestigious award recognizes our "Lifestyle Improvement For Everyone" (L.I.F.E.) program for excellence in worksite health promotion. This program was designed to monetarily reward our employees who choose to be responsible for their health and well being by participating in basic wellness activities such as aerobics, strength training, stress management, nutrition, and not smoking. It is employee-driven and supported throughout our organization. It pays to be healthy!
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Nationally recognized as a Gold Well Workplace!
The Wellness Council of America nationally recognized Physicians Health Plan as a healthy workplace on four separate occasions. This national, nonprofit membership organization is dedicated to promoting healthier lifestyles for all Americans, especially through health promotion activities at the workplace. Stringent guidelines must be met to receive the Gold Well Workplace designation. PHP is proud to offer our employees a healthy environment in which they have an opportunity to succeed!
Our smoke-free facility is conveniently located in Fort Wayne on West Jefferson Blvd next to I-69, and offers leading industry tools and equipment to allow our staff to excel in their areas of expertise.
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Women in Business - Company of Achievement
Awarded this designation by the YWCA's Tribute to Women of Achievement Program, PHP has been recognized for our pacesetting role in providing enhanced opportunities for women in business.
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Work Area Descriptions
Shown alphabetically by department name. Click on the link below to view the work description:
ACTUARIAL SERVICES
Responsibilities are:
- Establish premium base rates
- Analyze data/information
- Prepare and analyze group experience reports
- Prepare rate contract and filings for the Department of Insurance
- Prepare special reports for the Department of Insurance, Small Group Certification, and the Finance, and Employer Service Departments
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ADMINISTRATION
Responsibilities are:
- Interact with the Board of Directors
- Strategic planning
- Community relations
- Coach/facilitate Senior Management
- Establish Corporate policy
- Provide political representation
- Responsible for Profit & Loss of the Plan
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ANCILLARY SERVICES
Responsibilities are:
- Pharmacy provider education
- Dental provider education
- Newsletter to physicians/pharmacists/dentists
- Medication utilization review
- Cost-effective medication recommendations
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CONTRACT INSTALLATION AND ANALYSIS
Responsibilities are:
- Physician Profiles
- Physician payment schedules
- Develop pricing methodologies
- Implement contracts in the Claims system
- Analyze data and reports
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CLAIMS
Responsibilities are:
- Process all types of Medical, Dental, Hospital, and Pharmacy claims
- Coordinate benefits with other insurance carriers
- Correct payments to providers (over payments, refunds, etc.)
- Liaison with subrogation, repricing, and auditing vendors
- File maintenance of all paid claims (both onsite and offsite)
- Ensure accurate claims payment with system administration and benefit testing
- Member and physician inquiries
- System question and answer
- Provides back up for Customer Service
- System testing
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CORPORATE COMPLIANCE
Responsibilities are:
- Governmental affairs
- Contracts (language, filing, interpretation, etc.)
- Corporate compliance with laws and regulations
- ICHID and IAHP representation
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CUSTOMER SERVICE
Responsibilities are:
- Member claim issues
- Member/employer information source
- Provider eligibility issues
- Research and respond to all member and provider issues
- Appeals
- Provides back up for Claims
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EMPLOYER SERVICE
Responsibilities are:
- Support sales
- Open enrollment activity support
- Account/member retention strategies
- Employer training
- Liaison with employers
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ENROLLMENT
Responsibilities are:
- Data entry of member enrollment
- Generation of ID cards
- Maintenance of member files
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FINANCE
Responsibilities are:
- Financial statements
- Budget preparation and control
- Variance reports
- Billing of employer groups
- Cash/checks
- Purchasing supplies
- Accounts payable and receivable
- Risk management
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HUMAN RESOURCES
Responsibilities are:
- Recruitment
- Compensation program and benefit administration
- Payroll
- Employee orientation
- HR legal compliance
- Corporate policy and procedures
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INFORMATION SYSTEMS
Responsibilities are:
- Computer training
- Report generation and distribution
- Installation and maintenance of hardware/software/local area network
- Software development
- System updates
- Security access
- Telecommunications services
- Help Desk
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MARKETING
Responsibilities are:
- Advertising (all media)
- Competitive information
- Product development
- Community Relations Program
- Public Relations Program
- Distribution partnerships
- HealthNet newsletter
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MEDICAL MANAGEMENT
Responsibilities are:
- Authorizations
- Case management
- Utilization review
- Credentialing
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MEDICAL REVIEW SPECIALISTS
Responsibilities are:
- Complex claim review
- Grievance review
- Coding updates and clarification
- Accidental dental
- General dental
- Provide support to other departments
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OFFICE OPERATIONS
Responsibilities are:
- Inventory control
- General office equipment
- Building maintenance
- Incoming/outgoing mail
- Space planning
- Reception area
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PROVIDER SERVICES
Responsibilities are:
- Provider Network Establishment/Development/Maintenance
- Provider Education, Inservices, Updates
- Provider Contracting/Recontracting/Maintenance
- Provider Services/Issue Resolution
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SALES
Responsibilities are:
- New group sales
- Broker relations
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UNDERWRITING
Responsibilities are:
- Identifying acceptable financial risk
- New group underwriting and pricing
- Renewal group underwriting and pricing
- Audit of new groups
- Establishing underwriting guidelines/criteria
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