Participant service representative vs business representative

Differences between participant service representative and business representative duties and responsibilities

Participant service representative example responsibilities.

• Educate veterans and the college community on veteran's benefits and academic requirements need to accomplish academic goals.
• Educate employees in the FMLA process.
• Answer questions in regards to FMLA and payroll.
• Act as primary liaison between AVP and assign key clientele.
• Supervise multiple medical orders for largest AVP corporate account on a daily basis via telephone, fax and email.
• Submit insurance claims; review and problem-solve return, dispute, or reject claims from Medicare and other third-party payers.
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Business representative example responsibilities.

• Manage customer relations with internal personnel, group administrators, brokers and members as related to Medicare insurance.
• Verify ICD-9 to physician's diagnosis; insure correct CPT codes and level of service are going out on claims.
• Handle incoming calls to investigate and troubleshoot network and hardware concerns that align with company expectations of quality.
• Utilize multiple internal information systems and applications to troubleshoot hardware issues.
• Verify all new and returning patients' insurance coverage and eligibility when reviewing patient registration.
• Obtain and verify accurate and complete patient demographic information, appropriately schedule patients according to center and insurance guidelines.
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