Provider relations representative vs support representative

Differences between provider relations representative and support 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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Support representative example responsibilities.

• Educate veterans and the college community on veteran's benefits and academic requirements need to accomplish academic goals.
• Follow approved patient care algorithms to ensure patients receive quality care post surgically, while abiding by HIPAA regulations.
• Maintain personal patient information while following HIPAA regulations.
• Document department procedures; some convert into PowerPoint presentations.
• Follow all current Medicare, Medicaid regulations and requirements to ensure continual compliance.
• Provide hospital patients with assistance in obtaining proper medical coverage to cover medical expenses.
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