Provider Relations Specialist

Working remotely, the full-time Provider Relations Specialist will assist in provider relations and service interactions, analyzing medical bills, communicating with providers, and resolving billing inquiries in a timely manner. Key responsibilities Analyze medical bills based on various regulations and guidelines, ensuring accurate processing and communication of methodologies to providers Respond to provider inquiries via calls, emails, and voicemails within 48 hours, while monitoring the bill review process from receipt to final payment Collaborate with the Bill Review team on quality assurance issues and participate in ongoing training to enhance job skills Required qualifications High School Diploma required 2+ years of experience in complex Workers' Compensation Bill Review with customer service exposure Knowledge of medical terminology, CPT codes, and DRG Experience with hospital bill review is a plus CPC (Certified Professional Coding) coursework or certification is a significant advantage