Provider Relations Specialist
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Job Summary
Working remotely, the full-time Provider Relations Specialist will assist in provider relations and service interactions, analyzing medical bills, communicating with providers, and resolving billing inquiries in a timely manner.
Key responsibilities
- Analyze medical bills based on various regulations and guidelines, ensuring accurate processing and communication of methodologies to providers
- Respond to provider inquiries via calls, emails, and voicemails within 48 hours, while monitoring the bill review process from receipt to final payment
- Collaborate with the Bill Review team on quality assurance issues and participate in ongoing training to enhance job skills
Required qualifications
- High School Diploma required
- 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure
- Knowledge of medical terminology, CPT codes, and DRG
- Experience with hospital bill review is a plus
- CPC (Certified Professional Coding) coursework or certification is a significant advantage
Complete Job Description
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