Provider Relations Specialist

  • Correct Care Solutions
  • 168 Berrywood Dr, Hendersonville, TN 37077
  • Full-Time



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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.


Qualifications

Education:

  • Must have high school diploma or GED

Experience:

  • Experience with medical provider billing is helpful.
  • Must be proficient with Microsoft excel, Microsoft word and general typing skills.

Licenses/Certifications:

  • None required


Responsibilities

  1. Creates and maintains provider demographic records in claims transaction system.

  2. Updates W 9 s in claims transaction system and notifies appropriate parties.

  3. Reviews external preferred provider network data and updates claims transaction system.

  4. Processes manual eligibility for correct provider submission.

  5. 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.

  6. Must be able to apply sound judgment beyond a specific set of instructions and apply knowledge to different factual situations.

  7. Must be alert at all times; pay close attention to details.

  8. Must be able to work under stress on a regular or continuous basis.

  9. Perform other duties as assigned.

CCS is an EOE/Minorities/Females/Vet/Disability Employer



* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.