Provider Services Representative, Michigan
$16.50 - $19.75/hr
... contracting and risk arrangements, and actuarial precepts). * In-depth understanding of claims ... Hours Per Pay Period: 80 * On Call: No * Weekends: No
New
$16.50 - $19.75/hr
... contracting and risk arrangements, and actuarial precepts). * In-depth understanding of claims ... Hours Per Pay Period: 80 * On Call: No * Weekends: No
New
$16.50 - $19.75/hr
... contracting and risk arrangements, and actuarial precepts). * In-depth understanding of claims ... Hours Per Pay Period: 80 * On Call: No * Weekends: No
New
Education And Credentials Bachelor's degree in Mathematics, actuarial, finance, business, or ... No On Call Required : No With Rotation: Scheduled Work Hours: 8a-5p Work Arrangement : Onsite Union ...
Education And Credentials Bachelor's degree in Mathematics, actuarial, finance, business, or ... No On Call Required : No With Rotation: Scheduled Work Hours: 8a-5p Work Arrangement : Onsite Union ...
Duluth, GA · On-site
$115K - $123K/yr
... Actuarial systems. Requires in-depth knowledge and experience in front-end system development. Acts ... Provides on-call support for production and lower environments. * Provides training by working with ...
Duluth, GA · On-site
$115K - $123K/yr
... Actuarial systems. Requires in-depth knowledge and experience in front-end system development. Acts ... Provides on-call support for production and lower environments. * Provides training by working with ...
Duluth, GA · On-site
$115K - $123K/yr
... Actuarial systems. Requires in-depth knowledge and experience in front-end system development. Acts ... Provides on-call support for production and lower environments. * Provides training by working with ...
Duluth, GA · On-site
$115K - $123K/yr
... Actuarial systems. Requires in-depth knowledge and experience in front-end system development. Acts ... Provides on-call support for production and lower environments. * Provides training by working with ...
$22K - $34K
0% of jobs
$34K - $46K
1% of jobs
$46K - $58K
10% of jobs
$58K - $70K
13% of jobs
$70.9K is the 25th percentile. Wages below this are outliers.
$70K - $82K
17% of jobs
The median wage is $88.8K / yr.
$82K - $94K
16% of jobs
$105.8K is the 75th percentile. Wages above this are outliers.
$94K - $106K
18% of jobs
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12% of jobs
$118K - $130K
5% of jobs
$130K - $142K
5% of jobs
$142K - $154K
2% of jobs
$22K
$93.5K
$154K
$16.50 - $19.75/hr
Other
Posted yesterday
McLaren Health Plan (MHP) is a company with culture of high performance and a mission to help people live healthier, more satisfying lives. We are looking for a Provider Services Representative to join us in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offer multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary: This position will be responsible for daily provider telephone calls which will include problem solving, eligibility, benefit, and resolution of claims issues. Assists in providing linkage to the Medical Management Department for authorization of services. Being an advocate for the Provider, supplying information and education, and working with Provider Relations to handle issues. Also responsible for assisting members with eligibility, benefit, and resolution of claims issues as needed.
Qualifications:
Required:
High School Diploma or equivalent certification.
Two (2) years' experience in a physician health care office environment or high-volume call center.
Preferred:
Associate degree in business, health care, or related field.
Two (2) years' experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements, and actuarial precepts).
In-depth understanding of claims administration as it pertains to provider payments, including CPT-4 codes, revenue codes, HCPCS codes, DRGs, etc.
Sourced by ZipRecruiter
Outpatient health care
201 - 500 Employees
Flint, MI, US
1914