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Our Provider Relations Specialist will maintain provider demographic records within the claims transaction system and will match existing member eligibility to incoming provider claims for proper processing.
Creates and maintains provider demographic records in claims transaction system.
Updates W 9 s in claims transaction system and notifies appropriate parties.
Reviews external preferred provider network data and updates claims transaction system.
Processes manual eligibility for correct provider submission.
Must be able to apply principles of critical thinking to a variety of practical and emergent situations and accurately follow standardized procedures that may call for deviations.
Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations.
Must be alert at all times; pay close attention to details.
Must be able to work under stress on a regular or continuous basis.
Perform other duties as assigned.
CCS is an EOE/Minorities/Females/Vet/Disability Employer