CustomerExperienceAssociate II

MedRisk; Mandaluyong; On-site; PHP 420,000 - 520,000; Full time

Job summary

MedRisk is seeking a Provider Relations Representative in Mandaluyong, Philippines to handle inquiries from medical providers regarding workers’ compensation claims. You will use StrataWare, CompIQ and Call Track to answer, return, and manage calls while delivering prompt, courteous and professional customer service.

Responsibilities include handling calls with accuracy, understanding state workers’ compensation rules, and performing administrative tasks within 24 hours.

Qualifications

• Experience delivering high-quality customer service in a call center or service desk setting.
• Ability to navigate workers’ compensation guidelines and related processes.
• Strong data entry accuracy and attention to detail.

Responsibilities

• Provide prompt, courteous customer service for all calls with knowledge of workers’ comp guidelines.
• Work with StrataWare/CompIQ, Call Track, and client software to manage calls and tasks.
• Understand state rulings related to workers’ compensation and apply them in calls.
• Read and interpret medical bill processing rules and Bill Review Logs.
• Handle administrative tasks such as faxes, resubmitting bills, updating spreadsheets, and emails within 24 hours.
• Process medical bills, coding, or data entry with high accuracy during downtime or as assigned.
• Be adaptable with schedule changes to cover call centers between 8am–8pm, Mon–Fri.

Skills

Customer service

Call center experience

Data entry accuracy

Knowledge of workers’ compensation

Tools

StrataWare

CompIQ

Call Track

Job description

Job Description:

Job Summary

The Provider Relations Representative is responsible for answering phone inquiries pertaining to workers compensation claims from multi-state medical providers. An understanding of company computer systems, StrataWare, CompIQ and Call Track, is required to answer, return and manage calls. The primary function of the Provider Relations Representative is to provide prompt, courteous and professional Customer Service at all times.

Primary Responsibilities

1. Provide prompt, courteous and accurate customer service for all calls, with a solid understanding of worker’s compensation guidelines.


2. Working knowledge of StrataWare/CompIQ, Call Track, and any client proprietary software


3. Understanding of State rulings and regulations as relating to Workers’ Compensation.


4. Understanding of medical bill processing rules and guidelines, including how to read Bill Review Logs.


5. Perform administrative tasks such as managing faxes, resubmitting bills, updating spreadsheets, phone message retrieval, and e-mails within 24 hours, etc.


6. Processing medical bills, coding, or data entry with 98% accuracy during phone downtime or as assigned.


7. Be available to switch schedules, with little notice, between the hours of 8am and 8pm, Monday through Friday, to provide support coverage for our call centers.

Collateral Responsibilities

1. Demonstrate the ability to work both individually and in a team environment


2. Respond to provider issues and direct problem resolution


3. Set an example of courtesy and professionalism for all co-workers and customers


4. Complete additional work assignments as required by management

Requirements: