Provider Relations Specialist

Insurance Administrative Solutions•Clearwater, FL

1d•Onsite

About The Position

The provider specialist is responsible for maintaining control of the provider database in all aspects. Handles all provider-related claims issues with internal and external customers, processes electronic claims with provider-related problems, contacts providers when necessary and handles other provider information issues. Responsible for obtaining W-9s, as well as recognizing, researching and resolving any discrepancies noted. System generated provider reports are monitored and worked daily.

Requirements

High school education
Insurance, PC, Windows, and Word experience is required.

Nice To Haves

Excel experience is advantageous.

Responsibilities

Maintain provider database; adding new entries, making changes to provider information.
Process incoming provider correspondence.
Process electronic claims in a special provider mailbox.
Research provider checks returned by post office.
Utilize Excel spreadsheets for tracking purposes.
Handle provider-related problems that are referred to the unit from the claims departments.
Make and receive phone calls to and from providers.
Send correspondence to providers via mail, email or fax.
Review and process reports as assigned.
Log, research and update addresses for returned 1099’s
All duties above need to be performed with accuracy and speed.
Actively participate in cross training to maximize team efficiency and maintain or exceed service standards.