Provider Relations Associate Analyst

Immediate need for a talented Provider Relations Associate Analyst. This is a 06+ Months Contract opportunity with long-term potential and is located in U.S.(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-63394

Pay Range: $19 - $19.50/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• The primary responsibility of this role is to answer inbound claim calls from members or providers, as well as contracting and Provider Relations related calls from providers. 
• The work environment is structured, and the majority of the day will be spent answering these calls from a queue. 
• Occasional outbound calls may be necessary for issues requiring follow-up.
• Within a call a Claims & PR Advocate may:
• Assist a member or provider with understanding how a claim has processed.
• Verify claim status for a member or provider.
• Educate a member or provider on billing protocols.
• Write or correct authorizations to ensure claims are paid correctly.
• Send claims for adjustment/reprocessing.
• Request duplicate EOBs for a member or provider.
• Send a request for a cancelled check copy, to reissue a check, or request a stop pay/do not reissue on a check.
• Provide follow-up on issues by making outbound calls when necessary.
• Send resources to members and providers via email.
• Submit a complaint on the member or provider's behalf.
• Send handoff requets to matrix partners for escalated or complex issues.
• Assist providers with contract related inquiries and demographic updates.
• Independently problem-solve to ensure accurate information is given, exceptional customer service, and first call resolution is achieved.

Key Requirements and Technology Experience:

• Skills-Provider Relations Experience, Experience with claims, Behavioral Health and Environment Experience, Bachelor’s Degree.
• Customer Service experience
• Able to excel and/or prior successful experience in a virtual team environment.
• Ability to maintain a professional and positive image to members, providers, facilities, billing offices, etc.
• Candidate must possess superb interpersonal communication skills.
• Effective listening and organizational skills, with the ability to manage multiple tasks Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several claim systems and applications.
• Independent problem-solving skills.
• Strong time management skills.
• Ability to type effectively and have strong PC skills
• A bachelor's degree is required.

Our client is a leading Health insurance Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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