Provider Relations Specialist (On-Site)
The OccuNet Company · Amarillo, TX · 2 wk ago
On-siteHealthcareFull-time
Duties & Responsibilities
- Evaluate and respond to disputes from medical providers regarding claim processing and/or billing.
- Identify the issue at hand and determine the actions required to resolve the matter based on independent research and sound judgment.
- Follow up with medical providers as needed to ensure agreed upon actions are carried out (i.e., balance adjustments).
- Obtain new or missing documentation from medical providers and/or clients to ensure successful processing of medical bills.
- Respond to routine help desk inquiries from medical providers and clients, including status updates and pricing questions.
- Collaborate with internal colleagues to ensure consistent messaging and solution delivery for all clients and medical providers.
- Diligently adhere to all HIPAA laws, rules, and regulations.
- Maintain confidentiality of sensitive information.
Required Skills and Abilities
- Strong understanding of medical cost containment products including but not limited to reference-based pricing, out-of-network, and pharmacy benefits manager solutions.
- Knowledge in medical claims including CPT and ICD 10 coding, billing, or general medical insurance preferred.
- Excellent communication and interpersonal skills, written and verbal, with the ability to adapt appropriately for different audiences.
- Excellent time management and organizational skills.
- Able to multi-task effectively, transition between tasks frequently, and maintain focus when presented with interruptions.
- Strong computer skills, with a working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook, OneNote) and comfortability learning and navigating new systems.
- Investigative mindset, with the ability and drive to conduct independent research as needed.
- Adaptable to change.
- Team-first mindset with a high level of motivation, drive, and a desire to learn.
- Passionate and proactive about contributing to organizational missions with an emphasis on improving client and medical provider experiences.
- Strong attention to detail.
- Persistent and motivated to find a solution.
- Comfortable working in a fast-paced environment.
Benefits
- 401(k) with matching
- Dental insurance
- Health insurance
- Vision insurance
- Health savings account
- Paid time off