Offers “Dxc Technology”

Expires soon Dxc Technology

Provider Relations In House Support Representative

  • Tucker, USA

Job description


·  Job Description:

Reporting to the Provider Relations Supervisor, an In House Support Representative is responsible for assisting the Georgia Medicaid provider community with claims, provider enrollment and other duties as assigned.  Responsibilities include, but are not limited to:

·  Assisting as an In-House Support Representative to at least (2) Field Service Representatives.
·  Assisting providers with investigation of problematic claims
·  Monitoring and keeping abreast of billing manual changes as it relates to claims processing, etc. and their impact on the provider community
·  Interacting with DCH employees to resolve complex issues/topics that cannot be resolved in-house.
·  Meeting with providers that unexpectedly arrive at the Tucker office for claims resolution based on an assigned schedule
·  Monitoring and utilizing GAMMIS and related documentation to resolve claims processing issues within your assigned territory
·  Assisting FSRs with on-site training seminars and workshops, as required
·  Completing two provider visits per month with the assistance of a FSR.
·  Assisting with special projects as assigned by Supervisor (i.e. Call Center support)
·  Attending one monthly workshop and assisting the FSR with the presentation
·  Resolving and following-up on all open CTNs within 72 business hours of CTMS assignment
·  Reviewing and resolving special processing of claims (Special Batching).
·  Completing a weekly status report

Education and Experience Required:

- Bachelor's Degree (4 years) or equivalent Healthcare experience and one (1) year experience in the health care billing or healthcare public relations field (5 years total).

Knowledge and Skills:

- At least 2 years of Medicaid claims/policies and procedures knowledge preferred

- Experience resolving and following up on claims

- Strong Customer Service skills

- Strong Presentation skills

- Ability to work independently while traveling

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