Provider Services Rep

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 inquire
• 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
• 2+ years of experience in healthcare or insurance customer service

Advantages of this Opportunity:

• Pay $15/per hour
• Start Date: 7/13
• Long Term Contract Assignment

If you are interested, please call, Lovely 321-574-6539 and email your resume to me.

The greatest compliment to our business is a referral.

If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses of up to $100.00 for each placement.