Provider Relations Representative

Job Summary

To support efficient healthcare outcomes, the full-time remote Provider Relations Representative will initiate calls to confirm receipt of communications, respond to provider inquiries, and analyze documentation related to claims processing.

Key responsibilities

• Initiates phone calls to providers, pharmacies, patients, and carriers to confirm receipt of mailings and request actions
• Provides timely responses and resolutions for all provider-initiated inquiries via phone, email, or fax
• Reviews and analyzes documentation and claim data to determine validity and updates the accounts receivable system accordingly

Required qualifications

• High school diploma, GED, or equivalent work experience
• 2+ years of experience in claims processing or customer service in a healthcare setting
• Proficiency in Microsoft Word
• Ability to multi-task, prioritize, and organize effectively
• Experience with medical terminology and claims processing