Provider Relations Representative I

Cotiviti • Remote,

3d • Remote

About The Position

Cotiviti, Inc. drives better healthcare outcomes through data analytics. This means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality. Learn more at www.Cotiviti.com.

Requirements

• High school diploma, GED, or equivalent work experience.
• 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.
• Primarily sedentary work remotely.
• Ability to communicate and exchange information.
• Ability to comprehend and interpret documents and data.
• Communicating with others to exchange information.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.
• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands, and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
• No adverse environmental conditions are expected.

Responsibilities

• 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.
• Performs other functions as assigned.

Benefits

• medical, dental, vision, disability, and life insurance coverage
• 401(k) savings plans
• paid family leave
• 9 paid holidays per year
• 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED