Statement services representative vs provider relations representative

Differences between statement services representative and provider relations representative duties and responsibilities

Statement services representative example responsibilities.

• Manage customer relations with internal personnel, group administrators, brokers and members as related to Medicare insurance.
• Verify medicaid waive eligibility for non-emergency transportation.
• Copy documents according to instructions, binding and collating.

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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