Provider Service Representative
Position Purpose:
Responsible for resolving provider inquiries via telephone and email correspondence in a timely and appropriate manner. Provider inquiries including claims, eligibility, covered benefits, authorization status issues
- Document all activities for reporting and resolution through the customer relationship management application (CRM)
- Answer inquiries from providers regarding claim, eligibility, covered benefits, authorization status issues
- Provide first call resolution through issue documentation and resolution with appropriate internal resource, follow-up and ensure closure with the contact who initiated the inquiry
- Respond appropriately to provider issues and concerns, and provide trending feedback to improve the customer experience
- Process customer correspondence and provide the appropriate level of timely follow up
- Manage service related follow up items and outstanding tasks in accordance with established turnaround times
- Provide assistance to provider regarding website registration, navigation and customer related inquires-Educate provider on health plan initiatives during interactions with providers via telephone
- Maintain performance and quality standards based on established call experience guidelines
- Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations’ team for claim adjustment
- Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction
- Healthcare Experience at least I year
- HS Diploma or equivalent – Put education on resume
- 2+ years of experience in healthcare or insurance customer service
Advantages of this Opportunity:
• Competitive salary
• Fun and positive work environment
• Long Term Contract Assisgnment
• Can start on 7/13
Interested in being Considered?
If you are interested in applying to this position, APPLY NOW to Lovely Loriezo of Healthcare Support.