Here's an exciting career opportunity to become a part of one of the best places to work. We are looking for more smart, talented, passionate, loyal, and fun-loving individuals to become "Lucent Health" - the face, the voice, and the behavior that represents the quality of who we are to those we serve!
The purpose of the Provider Relations Representative is to provide exceptional customer service by supporting our Claims team and responding to inquiries from providers. Provider Relations Representatives answer provider inquiries regarding verification of benefits and Claims status for medical and dental claims. Provider Relations Representatives also provide a variety of other duties and projects assigned by Management to support the company. Some of these duties include: entering precertification’s into the claims processing system, working miscellaneous claims queues, processing pharmacy claims, sending out correspondence, outbound provider call projects, and reviewing claims spreadsheets and plan documents.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Provide responsive and professional customer service to providers regarding status of medical and dental claims.
- Utilize necessary resources and navigate systems efficiently to accurately verify eligibility and provide verification of benefits.
- Assist providers in getting set up and utilizing Provider Portal
- Maintain a positive and professional attitude.
- Work with members of staff on identifying process improvements
- Perform other duties as assigned by management.
- Report to work on a consistent, regular basis during core business hours (8:00 a.m. – 5:00 p.m.).
Thorough understanding of Self-Funding Insurance and Third-Party Administrating concepts. Demonstrated written and oral communication skills required. Strong organizational skills, problem solving, and decision-making skills required. Knowledge in Excel and Word. Ability to navigate through and utilize various PC applications efficiently. Self-direction and self-starter skills required. Experience in medical and dental terminology, coding, and/or claims processing.
1-2 years previous Insurance experience strongly desired.
Equal Employment Opportunity Policy Statement
Lucent Health Solutions, Inc. is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, genetic information, gender identity, gender expression, transgender status, arrest record, or any other characteristic protected by applicable federal, state or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.