About this role

Take inbound calls answering questions from providers and their staff members
Answer complex questions regarding coverage, benefits and other inquiries
Provide excellent customer service with a goal of first call resolution
Research and respond to provider inquiries and escalated calls
Work cohesively with parties to resolve issues and deliver customer service
Provide timely information to providers regarding claims and payments
Identify and resolve managed care issues concerning claims
Assist in resolving provider appeals and provide education to physicians and their staff
Work on special projects as assigned
Meet quality, quantity, and timeliness standards

High school diploma/GED or equivalent working knowledge
3 to 4 years of experience in a high volume service center or managed care environment
Background in medical billing, medical claims, customer service, and managed care
Ability to multitask between inbound calls and resource tools
Excellent communication skills, both verbal and written
Organizational skills and operational knowledge of work processing, spreadsheets, data entry, etc.

Provider Experience Center Representative

Key skills