Job Summary
The Provider Relations Representative is responsible for answering phone inquiries pertaining to workers compensation claims from multi-state medical providers. An understanding of company computer systems, StrataWare, CompIQ and Call Track, is required to answer, return and manage calls. The primary function of the Provider Relations Representative is to provide prompt, courteous and professional Customer Service at all times.
Primary Responsibilities
- Provide prompt, courteous and accurate customer service for all calls, with a solid understanding of worker’s compensation guidelines.
- Working knowledge of StrataWare/CompIQ, Call Track, and any client proprietary software
- Understanding of State rulings and regulations as relating to Workers’ Compensation.
- Understanding of medical bill processing rules and guidelines, including how to read Bill Review Logs.
- Perform administrative tasks such as managing faxes, resubmitting bills, updating spreadsheets, phone message retrieval, and e-mails within 24 hours, etc.
- Processing medical bills, coding, or data entry with 98% accuracy during phone downtime or as assigned.
- Be available to switch schedules, with little notice, between the hours of 8am and 8pm, Monday through Friday, to provide support coverage for our call centers.
Collateral Responsibilities
- Demonstrate the ability to work both individually and in a team environment
- Respond to provider issues and direct problem resolution
- Set an example of courtesy and professionalism for all co-workers and customers
- Complete additional work assignments as required by management
