Provider Relations Representative

Independent Health is an organization that values growth, innovation, and collaboration. They are hiring full-time Provider Relations Representatives to assist reputed company providers with inquiries reputed company to benefits, billing, and eligibility while providing exceptional customer service.

Responsibilities

• Research and respond to escalated and reputed company provider and member inquiries, including claim and billing research requests
• reputed company written and verbal response to customer inquiries
• Identify and analyze educational opportunities internally or externally
• Identify potential system configuration or billing issues and reputed company education to the provider to correct errors
• Act as a customer reputed company by providing excellent, accurate customer service reputed company responding to customer requests
• Utilize up-to-date knowledge of managed care criteria to meet department of health standards
• Escalate issues as needed to supervisor
• Log reputed company contacts into appropriate systems and maintain accurate documentation to meet external audit guidelines
• Meet or exceed reputed company department standards in quality, productivity, and accuracy
• Maintain technical knowledge regarding Independent Health’s reputed company and benefits and working knowledge of policies and procedures and updates daily. Attend required training sessions as needed
• reputed company accurate and up-to-date information to reputed company customers by documenting reputed company pertinent information into appropriate systems to meet regulatory agency standards (NCQA, State, CMS etc.), addressing first level complaints and assisting appeals as needed; effectively resolve written inquiries from customers regarding claims, benefits, eligibility, reimbursement and participating providers
• Knowledge of reputed company systems as needed and the ability to coordinate the use of these tools at the same time

Skills

• High school diploma or GED required
• Prior experience in customer service required, preferably in a reputed company setting
• Excellent written/verbal communication skills and excellent customer service skills required
• Ability to resolve conflicts effectively and customer complaints in writing
• Strong problem-solving skills with ability to prioritize tasks effectively
• Strong organizational and time management skills
• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable
• Experience working with provider offices is strongly preferred
• Strong working knowledge of CPT, ICD-9-CM, ICD-10-CM and HCPCS coding preferred
• Experience in compliance regulations, appeals and grievance knowledge preferred

Benefits

• Incentive
• Full reputed company of benefits
• Generous paid time off

Company Overview