North Carolina Qualified Professional

Job Summary

Assisting providers with inquiries related to claims and services, the full-time hourly MRS Provider Support Line Representative will manage incoming calls, document interactions, and provide high-quality customer service while working remotely from North Carolina.

Key responsibilities

• Handle telephonic requests from network providers, providing information and support regarding claims, authorizations, and services
• Document all calls and interactions in the electronic information system, ensuring accurate and timely record-keeping
• Assist with specialized projects and reviews as requested by management, contributing to departmental initiatives

Required qualifications

• Bachelor's degree in a Human Services field with at least two years of relevant experience, or a Bachelor's degree with four years of experience in a similar setting
• Qualified Professional status according to 10A NCAC 27G .0104
• Experience in network management or handling complex network providers in the healthcare industry is preferred
• Knowledge of mental health, substance use, and developmental disability services in North Carolina
• Ability to work with confidential healthcare information in compliance with HIPAA and other relevant laws