Provider relations representative vs service center representative

Differences between provider relations representative and service center representative duties and responsibilities

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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Service center representative example responsibilities.

• Educate veterans and the college community on veteran's benefits and academic requirements need to accomplish academic goals.
• Ensure that all telephone calls and pages are promptly handle in the best interest of Dartmouth-Hitchcock internal and external patients.
• Maintain resident and guest confidentiality with strong understanding of HIPAA and privacy laws.
• Assist participants with the benefit enrollment process by explaining types of insurance policies and IRS regulate spending accounts.
• Instruct active and terminate participants with withdrawal options, process hardships and loans while also explaining IRS 1099R information.
• Assist participants with inquiries relating to administration of healthcare reimbursement plans (FSA, HRA/HSA, and VEBA).
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