Provider Relations Representative
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.
Key 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.
Required Qualifications:
Bachelor’s degree in a healthcare or business-related field, or equivalent experience.
Minimum of one (1) year Customer Service experience (voice) or experience in medical billing or healthcare claims review.
Ability to learn ICD-9/ICD-10 and CPT/HCOC coding
Ability to use Microsoft Windows-based software
Ability to learn and apply basic medical terminology
Excellent oral and written English skills
Ability to assess and document reconsideration issues based on caller’s issue
Ability to work in a team environment
Minimum one (1) year of Customer Service experience (voice)
Candidate must be available to work an 8-hour shift any time between 8:00 AM and 8:00 PM EST, Monday to Friday. Expected to work on Philippine holidays, but you will have U.S. holidays off.
Preferred Qualifications:
Two (2) years experience in Workers’ Compensation
Two (2) years experience in a medical setting
Six (6) months experience in Bill Review Department
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All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, or any other characteristic protected by law.
Genfinity as an Equal Opportunity Employer, believes in each person’s potential, and we’ll help you achieve yours.
All information will be kept confidential according to EEO guidelines.
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We value your privacy. By submitting your information through this form, you are applying for a position at Genfinity Philippines, Inc. and voluntarily providing personal information, including your name, contact details, and resume.
This information will be collected and processed solely for recruitment purposes, including evaluating your qualifications, verifying your background, and contacting you about your application. Your personal data will be processed in accordance with the Data Privacy Act of 2012.
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