Representative vs business representative

Differences between representative and business representative duties and responsibilities

Representative example responsibilities.

• Manage fitting rooms and recover the department, while providing exceptional customer service and offering rewards and POS options.
• Manage physical portfolio with necessary derivatives to mitigate risk within company guidelines.
• Conduct telephone sales and interviews, compile and enter information into database, manage documents and insure customer satisfaction.
• Review EOB denials, appeals and/or rebilling as appropriate.
• Certify of all requirements, policies, and procedures, including MSB.
• Take inbound phone calls from member and providers explaining the EOB denial and payments
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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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