Provider Relations Specialist

Description:

Assists providers via phone and email with basic to complex bill review questions and requests. Documents bill review errors for tracking and trending to improve team error rate. Acts as a positive and professional representative of our organization; ensures compliance with company best practice standards; ensure consistent, timely delivery of our quality services.

Fully Remote after 2-week onsite training period. Must be commutable to Lake Mary, FL

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Communicate clearly and professionally with callers and via email.
• Maneuver in the bill review application to obtain accurate information for the callers.
• Understand EORs as well as client-specific nuances.
• Answer basic to complex State WC fee schedule and/or billing questions on processed medical bills covering regular as well as facility bill types
• Understand and be able to properly explain provider contracted rates, carve-outs and special LOAs applied to medical bills
• Requires regular and consistent attendance.
• Ability to control phone calls to ensure timely resolution and lower provider hold times.
• Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).

KNOWLEDGE & SKILLS:

• Previous experience within provider relations, bill review, claims, workers compensation, etc. 
• Customer service experience working in the Managed Care and Benefit Administration industries, preferred.
• Excellent oral and written communication skills
• Strong customer service skills and experience
• Strong organizational skills. Excellent interpersonal skills
• High School Diploma or equivalent required. 

Details: 

• Fully remote after 2-week onsite training period. Equipment is provided
• Pay: $16/hr. - $18/hr.
• Pay cycle – weekly | Medical, Dental & Vision benefits offered. 
• Training Schedule: Monday – Friday | 8-hour shift between 8:00am – 5:00pm EST. **Training will be fully onsite for the first 2 weeks. Must be commutable to Lake Mary, FL
• Full time schedule: Monday – Friday | 7:00am – 330pm, 8:00am – 430pm, or 8:30am – 5:00pm EST. Flexibility to choose either shift as long as it’s consistent.