Provider Network Services Call Center & Enrollment Rep

Job summary
Responsible for handling incoming calls and written correspondence from professional providersServe as a resource for internal departments within the organizationReview credentialing applications and provide support for Professional Relations Representatives
Job seniority: associate level
Responsibilities
• Answer questions accurately and in a timely manner• Educate providers on correct claim coding• Research claim payment and coding problems• Refer inaccurately processed claims to be adjusted• Review contract application status• Assist with utilization and special report requests• Understand provider contracting process• Review credentialing applications• Serve as a resource for internal departments• Educate providers on website services and navigation
Requirements
• High school graduate or equivalent• 2 years of BCBSKS operations experience or 3 years of medical insurance experience• Excellent verbal and written communication skills• Knowledge of ICD-10 and CPT coding preferred• Proficiency in Microsoft Suite applications preferred
Key Skills Needed
• Customer service• Claims processing• Membership auditing• Medical insurance knowledge• Verbal and written communication• Human relation skills• ICD-10 and CPT coding• Microsoft Suite applications
Benefits
• Paid vacation and sick leave• Paid maternity and paternity leave• Dynamic work environment• Trust in the company• Stability• Inclusive work environment