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Provider Billing / Customer Service Representative

Company: A-Line Staffing Solutions
Location: Arlington
Posted on: February 15, 2020

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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