Remote Provider Relations & Bill Review Specialist

EK Health Services Inc.; Sparks (NV); Remote; USD 26,000 - 29,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

401K

Paid Time Off

Paid Holidays

Monthly internet stipend

Equipment provided

Job summary

EK Health Services Inc. is seeking a Provider Relations Specialist to assist in comprehensive provider relations and service interactions with EK Health clients and partners. The role collaborates with the Bill Review team to resolve bill processing requests.

Responsibilities include analyzing medical bills, communicating methodologies to providers, and ensuring timely responses to inquiries while upholding high standards of customer service and compliance.

Qualifications

• High School Diploma required.
• CPC coursework or certification is a big plus.
• Knowledge of medical terminology, CPT codes, and DRG.

Responsibilities

• Analyze medical bills based on jurisdiction, UCR, regulations, contracts and guidelines.
• Explain to providers how bills are processed and re-priced.
• Receive provider inquiries and respond within 48 hours.
• Monitor bill review through to final payment.
• Verify proper coding and report misuse to QA.
• Support quality assurance with the Bill Review team.
• Communicate with providers, clients and adjusters with professional service.
• Participate in ongoing training and other duties as assigned.

Skills

Customer service

Medical terminology

CPT codes

DRG knowledge

Communication skills

Interpersonal skills

Education

High School Diploma

CPC coursework or certification

Tools

MS Word

MS Excel

Email

Job description

EK Health Services Inc. is seeking a Provider Relations Specialist to assist in comprehensive provider relations and service interactions with EK Health clients and partners. The role collaborates with the Bill Review team to resolve bill processing requests.

Responsibilities include analyzing medical bills, communicating methodologies to providers, and ensuring timely responses to inquiries while upholding high standards of customer service and compliance.