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Provider Relations Representative
•30 days ago
| Hours | Full-time |
|---|---|
| Location | 4550 John F Kennedy Blvd., Suite C North Little Rock, Arkansas |
About this job
Maintain provider information in the system, complete system payment runs and interface with the provider community in order to maintain system data for daily operations.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Update and maintain the Preferred Provider Directory.
Complete QA processes to ensure the Preferred Provider Directory is displayed correctly.
Complete provider updates according to department standards.
Verify correct addresses for returned mail.
Return invalid claims to provider and update system information when valid information is returned.
Write up appeal priorities and disperse as required.
Assist members and provider with network status of providers.
Produce Preferred Provider Directory's as requested.
Assist with quarterly Board of Trustee meetings.
Report status of ongoing tasks to Provider Relations Supervisor.
Support help for other staff as needed.
Maintains a professional demeanor both in person and over the phone.
Performs any other duties as required or assigned.
EDUCATION AND EXPERIENCE
High school diploma or GED and two (2) years of medical insurance experience dealing with but not limited to provider relations, claims processing and data entry. Strong sense of excellent customer service. Good organizational skills and abilities. Strong analytical skills for data compiling and utilization. Excellent in Microsoft Office. Must possess the ability to work independently with little supervision.
LANGUAGE SKILLS
Strong sense of customer service. Good organizational skills and abilities. Ability to respond to common inquiries or complaints from customers, health providers, or members of the business
Staffmark is committed to providing equal employment opportunity for all persons regardless of race, color, religion, sex, sexual orientation, gender identity, age, marital status, national origin, citizenship status, disability or veteran status.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Update and maintain the Preferred Provider Directory.
Complete QA processes to ensure the Preferred Provider Directory is displayed correctly.
Complete provider updates according to department standards.
Verify correct addresses for returned mail.
Return invalid claims to provider and update system information when valid information is returned.
Write up appeal priorities and disperse as required.
Assist members and provider with network status of providers.
Produce Preferred Provider Directory's as requested.
Assist with quarterly Board of Trustee meetings.
Report status of ongoing tasks to Provider Relations Supervisor.
Support help for other staff as needed.
Maintains a professional demeanor both in person and over the phone.
Performs any other duties as required or assigned.
EDUCATION AND EXPERIENCE
High school diploma or GED and two (2) years of medical insurance experience dealing with but not limited to provider relations, claims processing and data entry. Strong sense of excellent customer service. Good organizational skills and abilities. Strong analytical skills for data compiling and utilization. Excellent in Microsoft Office. Must possess the ability to work independently with little supervision.
LANGUAGE SKILLS
Strong sense of customer service. Good organizational skills and abilities. Ability to respond to common inquiries or complaints from customers, health providers, or members of the business
Staffmark is committed to providing equal employment opportunity for all persons regardless of race, color, religion, sex, sexual orientation, gender identity, age, marital status, national origin, citizenship status, disability or veteran status.
Requirements
High school diploma or GED and two (2) years of medical insurance experience dealing with but not limited to provider relations, claims processing and data entry. Strong sense of excellent customer service. Good organizational skills and abilities. Strong analytical skills for data compiling and utilization. Excellent in Microsoft Office. Must possess the ability to work independently with little supervision.