The CSI Companies is currently seeking a Provide Relations Representative to support one of our clients in the Las Vegas, NV area. This healthcare company provides cost effective solutions and coordination of benefits to customers in order to save billions of dollars a year helping to make the healthcare system better for everyone. This person will be responsible for interfacing with the Physician/Provider population to recover payment on behalf of clients.
• Initiates phone calls to customers, (providers/pharmacies/patients/carriers etc.) to confirm receipt of mailings, and to request action.
• Provides timely response and resolution for all provider initiated inquires (phone calls, emails or faxes).
• Reviews and analyzes documentation and claim data to determine validity and proper action.
• Updates accounts receivable system with denial and group information.
• Assists with high priority special projects.
• High School Diploma or GED required
• 2+ years’ experience as an examiner/processor with exposure to medical terminology and claim processing experience in Commercial Insurance or Government Programs required
• 2+ years previous experience in a claims customer service environment OR 2+ years of answering inbound calls regarding claims processing
• Ability to work proficiently with Microsoft Word.
• Ability to multi-task and prioritize.
• Ability to be careful and thorough about detail.
• Ability to organize well.
• Ability to demonstrate a customer service orientation.