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.