About the Role
The Provider Call Center Representative is responsible for maintaining excellent relationships with health providers and facilities by responding to their phone inquiries efficiently, professionally, and accurately. You will respond to provider calls related to claim status, denials, and re-submission of claims. You will instruct providers regarding how to use the provider portal on the website, and be able to successfully add and manage users for the provider portal. You must be able to work in a fast paced environment and be able to handle claims processing duties and projects while not handling telephone calls. The position requires a complete understanding of how claims are processed and established guidelines and procedures in order to accurately answer phone inquiries.
Requirements
Essential Functions and Responsibilities
Answer provider phone calls
Effectively communicates status of claim/line item
Follow-up with providers appropriately and responds promptly to all requests
Document provider interactions in the designated application ensuring provider issues are appropriately identified, documented, communicated, and resolved in a timely manner
Assist providers with provider portal navigation
Identify possible claims issues and forward these to the appropriate staff
Process claims to fill time in between incoming calls
Required Skills & Abilities
High School Diploma or equivalent
1-3 years of experience with inbound calls related to claims
Proficient in Microsoft Office suite with 10 key entry; minimum typing speed of 45 wpm
Good verbal and written communication skills
Ability to work independently
Ability to be adaptable and offer creativity in a continually changing environment
About the Company
The foundation of Productive Programming, Inc. (PPi) is built upon the passion and dedication we have for helping you create the best care management program for your members. You are passionate about helping others and we want to provide the support your program requires to thrive. PPi offers Care Compass, integrated and customizable software, to help administer your team-based, long-term care management services