Provider Relations Specialist I/Ii

This position is an in office position and requires the candidate to be onsite. Starting pay for this role is $19.89.

SUMMARY:

Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate payment information to internal and external customers.

PRIMARY RESPONSIBILITIES:

• Utilizes ACD phone lines to manage incoming calls and inquiries.
• Provides high level of customer service for all internal or external customers thru telephonic, email and fax.
• Demonstrates a dependable work ethic.
• Manages confidential client information with discretion and good judgment in accordance with department and company guidelines.
• Identifies problems, provides solutions and resolves promptly, escalating more complex problems appropriately.
• Review state reporting criteria as related to bill processing and outlined in state guidelines.
• Refers to reference library of fee schedules, CPT, ICD-CM, HCPCS and other industry publications to support findings.
• Review, analyzes, adjusts and releases basic bills including duplicates.
• Responds to written or verbal provider inquiries relating to our bill review analysis.
• Analyzes problems using problem solving methodology skills to determine root cause; communicates and implements solutions.
• Types, photocopies, faxes as necessary.
• Create reconsiderations for processing.

This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:

EDUCATION REQUIRED:

Provider Relations Specialist I

High School Diploma or G.E.D.

Medical billing and coding certificate or degree program Required.

EXPERIENCE REQUIRED:

Provider Relations Specialist I

• Minimum of three-year general office experience including answering inquiries over the phone or equivalent relevant experience that would provide the required skills, knowledge, and abilities.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Basic knowledge of medical terminology, anatomy, CPT, ICD-CM codes and medical fee schedules.
• Excellent customer service skills.
• Excellent telephone etiquette.
• Ability to obtain pertinent and thorough information from customers
• Knowledge of computers and spreadsheet software.
• Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.
• Ability to perform mathematical calculations with the ability to use a ten-key pad with accuracy.
• Ability to manage work with minimal direction.
• Excellent oral and written communication.
• Demonstrate attention to detail.
• Ability to consistently meet or exceed daily production and quality standard for this position.

ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:

• Basic knowledge of Claims process
• Experience on an ACD telephone system

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

REQUIRED TESTING:

10 Key, Math, Reading Comprehension, Basic Excel

Job Type: Full-time

Pay: From $19.89 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Medical billing: 1 year (Required)
• Office: 3 years (Required)

License/Certification:

• Medical Billing Certification (Required)

Work Location: In person