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Provider Relations Specialist

Chicago, IL 60608

Posted: 05/02/2022 Industry: Medical Financial Services Job Number: LB297442113 Pay Rate: 20

Job Description

Due to the growth and expansion of services, this Chicago based benefits administration firm is seeking an experienced PROVIDER RELATIONS SPECIALIST to provide superior level of customer service to their 20,000+ employees.  You will become a member of a growing team and be responsible for an assigned number of claims to process with minimal supervision in a hybrid work environment.
 
Provider Relations Specialist’s Responsibilities
  • Establish and build relationships with healthcare systems and medical providers as well as providing support to the Member Services staff to resolve more complex provider inquiries
  • Handle all provider inquiries (via email, phone or mail) documenting discussions, issues and researching claims issues to the appropriate individual
  • Process denied claims 
  • Educate providers regarding policies and procedures related to referrals and claims submission, plan design education and Electronic Data Interchange (EDI) questions
  • Partner with Network Supervisor to create technical manuals, policies and procedures, training materials and project plans to assist with training of staff and providers
  • Maintain high level of confidentiality and integrity in confidential information
  • Daily interaction with all levels of personnel including peers, executives, Administrators and external partners 
 
Provider Relations Specialist’s Qualifications
  • Associates degree or higher in Health Care, Business Administration or similar field
  • Minimum of 1 year of experience in employer benefit plan administration systems
  • 3+ years of provider relations and/or provider network experience 
  • Understanding of healthcare claims 
  • Ability to analyze data to resolve provider service issues
  • Knowledge and understanding of the healthcare industry including medical claim processing, ICD-10 diagnosis codes, CPT procedures coding, HCPC codes, HCFA 1500 and UB-02 claims
  • Taft-Hartley experience preferred
  • HPS or basys knowledge 
 
Company Culture & Perks
  • High visibility role with potential to learn and grow within the organization
  • Strict protocols in place for COVID safety and security in the office
  • Generous time off schedule including 17 days PTO after one year AND 15 Holidays 
  • HYBRID work environment with a Monday thru Friday work schedule offering 37.5 hour work week
  • Defined benefit pension plan offered after 3 years of employment
  • Education reimbursement after 1 year of employment
  • Remote set up for home office provided including laptop and headset
  • Easy access from Orange line with a 5 minute walk OR bus stop located on the same block
  • Easily accessible to shopping and restaurants
  • Company rewards and recognizes hard work 
  • Company offers career development and continuing education opportunities
  • Temp to hire position offering a comprehensive benefits package including medical, dental and vision insurance and disability while you work towards being hired full-time.  Once hired full-time, you and your family will enjoy a benefits package including health coverage (medical, dental & vision), competitive compensation, generous holidays and PTO policies and a pension retirement plan.
 
Salary:  $19.00 - $21.00 an hour
 
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Meet Your Recruiter

Laura Bowen, CTS | CSC
President

Laura has over twenty-five years of experience in the staffing and recruiting industry. An integral part of creating and developing ExecuTeam’s Healthcare division, Team1Medical, Laura became President of both ExecuTeam and Team1Medical in 2013. Her collaborative approach creates long lasting professional relationships while providing the highest level of service to her team, clients and candidates. With a bachelor’s degree from the University of Houston, Laura remains active with alumni functions. Laura has served ten consecutive years on the executive board of HAAPC – Houston Area Association of Personnel Consultants including two years as President. Since earning her CTS accreditation in 1996, she continues to attend several national staffing conferences to stay current on policies and industry changes. As of December 2020, Laura also earned her CSC accreditation. Laura has been an integral part in growing and developing ExecuTeam & Team1Medical Staffing into the award-winning company of today.

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