Provider Billing / Customer Service Representative
Company: A-Line Staffing Solutions
Location: Arlington
Posted on: February 15, 2020
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Job Description:
A-Line Staffing is now hiring Provider Billing / Customer
Service Representative in Arlington, TX.--The Provider Billing /
Customer Service Representative--would be working for a Fortune 500
company and has career growth potential. This would be full time /
40+ hours per week.--Provider Billing / Customer Service
Representative--Highlights:This position pays $12 to $13
hourlyProvider Billing / Customer Service Representative--Job
Description:Explains member's rights and responsibilities in
accordance with the contract.Processes claim referrals, new claim
handoffs, nurse reviews, complaints (member/provider), grievance
and appeals (member/provider) via the target system.Educates
providers on our self-service options; Assists providers with
credentialing and re-credentialing issues.Responds to requests
received from Aetna's Law Document Center regarding litigation;
lawsuits.Handles extensive file review requests. Assists in the
preparation of complaint trend report. Assists in compiling claim
data for customer audits.Determines medical necessity, applicable
coverage provisions and verifies member plan eligibility relating
to incoming correspondence and internal referrals.Handles incoming
requests for appeals and pre-authorizations not handled by Clinical
Claim Management.Performs review of member claim history to ensure
accurate tracking of benefit maximums and/or
coinsurance/deductible. Performs financial data maintenance as
necessary.Uses applicable system tools and resources to produce
quality letters and spreadsheets in response to inquiries
received.If you think this Provider Billing / Customer Service
Representative--position is a good fit for you, please reach out to
me - feel free to call, e-mail, or apply to this posting!Sayed
Ahmed586-323-4197[Click Here to Email Your Resum--] Provider Claims
or Medical Billing experience 2+ recent years in a High Volume Call
Center experience (please specify call amount of calls handled on
resume or comments.) Looking for candidates with proven success in
a call center role - Please do not submit candidates that have only
worked short-tenured roles in call centers High School Diploma or
GED Attendance is mandatory for the first 90 days
Keywords: A-Line Staffing Solutions, Arlington , Provider Billing / Customer Service Representative, Accounting, Auditing , Arlington, Texas
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