Provider Relations Representative

Company: Lucent Health Solutions LLC
Location: Appleton
Posted on: January 16, 2022

Job Description:

Provider Relations Representative Job DescriptionRole Summary The primary focus of the Provider Relations Representative is to answer provider inquiries regarding verification of benefits and claims status for medical and dental claims; entering precertification's into the claims processing system, working miscellaneous claims queues, sending out correspondence, outbound provider call projects, and reviewing claims spreadsheets and plan documents. Daily role responsibilities:Works collaboratively with claims administration for Lucent Health client groups. Provide responsive and professional customer service to providers regarding status of medical and dental claims.Utilize necessary resources and navigate systems efficiently to accurately verify eligibility and provide verification of benefits.Assist providers in getting set up and utilizing Provider PortalMaintain a positive and professional attitude.Work with members of staff on identifying process improvementsPerform other duties as assigned by management.Report to work on a consistent, regular basis during core business hours (8:00 a.m. - 5:00 p.m.).This position could be a good fit if you have:High School Diploma / GED (or higher) 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools preferred.Strong organizational skills, problem solving, and decision-making skills required. Ability to navigate through and utilize 25+ PC applications efficiently. Knowledge in Excel and Word.Self-direction and self-starter skills required. Demonstrated written and oral communication skills required.Other DutiesPlease note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Physical and Emotional Demands: While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.Equal Employment Opportunity Policy StatementLucent Health Solutions, Inc. is an Equal Opportunity Employer. PI160835967

Keywords: Lucent Health Solutions LLC, Appleton , Provider Relations Representative, Other , Appleton, Wisconsin