Circulation representative vs provider relations representative

Differences between circulation representative and provider relations representative duties and responsibilities

Circulation representative example responsibilities.

• Conduct telephone sales and interviews, compile and enter information into database, manage documents and insure customer satisfaction.
• Verify medicaid waive eligibility for non-emergency transportation.
• Conduct telephone sales and interviews, compile and enter information into database, manage documents and insure customer satisfaction.

Provider relations representative example responsibilities.

• Help manage ACO program and review measures with provider offices.
• Advise clients on health care and manage care products including POS, PPO and medical management programs.
• Provide keen oversight in developing and maintaining quality improvement programs while managing payroll.
• Manage software maintenance renewal partner and assist with upselling additional and higher functionality licenses to increase revenue.
• Review the provider contracts, paid members claims, base on the CPT code & ICD-9 that are submitted.
• Review provider claims for CPT and ICD-9 coding accuracy and generate payment of claims base upon current fee schedule.
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