Xerox Provider Relations Specialist in Amarillo, Texas
Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing services, including data processing, healthcare solutions, HR benefits management, finance support, transportation solutions, and customer relationship management services for commercial and government organizations worldwide. The company also provides extensive leading-edge document technology, services, software and genuine Xerox supplies for graphic communication and office printing environments of any size. Xerox serves clients in more than 160 countries. For more information, visit www.xerox.com, www.news.xerox.com, www.realbusiness.com or www.xerox.com/businessservices.
If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.
Provider Relations Specialist
Responsible for addressing appeals received from Health Care Providers for assigned client case load via telephone or written correspondence, ensuring adherence to State guidelines.
MAIN DUTIES AND RESPONSIBILITIES (Essential Functions of the Position):
Responds to written and verbal provider inquiries relating to our bill review analysis. Analyzes problems using problem solving methodology skills to determine root cause; communicates and implements solutions.
Resolves issues successfully in a proactive and timely manner. Communicates outcome to client services department.
Provides proactive service for assigned clients including issue resolution, education and interpretation of state specific fee schedules, rules, regulations and guidelines.
Refers to reference library of fee schedules, CPT, ICD-9, HCPCS and other industry publications to research and support findings.
Acts as primary liaison between provider and StrataCare.
Identifies training and system deficiencies and issues; reports to Manager.
Documents activities in monthly meetings log.
Communicates with State’s Workers’ Compensation agencies
Provides the highest level of customer service to customers, whether these are current or prospective clients of the Company, vendors, staff, business partners or visitors.
Assists and cooperates with co-workers, supervisor and management.
Retrieves data and prepares reports.
Identifies problems, provides solutions and resolves promptly. Escalates more complex problems to the next level.
Manages confidential client, financial and employee information with discretion and good judgment in accordance with department and Company guidelines.
Demonstrates a dependable work ethic.
Collaborates with supervisor to develop skills and knowledge.
To perform effectively in this position, the incumbent is required to have:
Comprehensive knowledge of the Official Medical Fee Schedule and California medical/legal schedules.
Thorough knowledge of the State of California Labor Code and its rules and regulations.
Familiarity with other States’ Rules and Regulations.
Thorough working knowledge of Company products, department policies, procedures and generally accepted Provider Relations practices.
Previous experience in workers’ compensation industry.
Excellent negotiation skills.
Thorough understanding of healthcare cost containment industry.
Experience in dealing with dated materials and strict time limits.
Ability to work independently, analyze business information and arrive at sound recommendations.
Ability to read, learn and retain Workers’ Compensation regulations.
Proven ability to build/maintain relationships at all levels.
Effective interpersonal and customer service skills.
Effective oral, written and communication skills.
Good organizational skills.
Competency to utilize Company software and proficiency in Microsoft software applications and a willingness to learn new systems as necessary.
Ability to work overtime as needed.
Typically these skills result from high school graduation and five or more years’ workers’ compensation/medical bill review experience.
WORK ENVIRONMENT/DEMANDS OF THE POSITION:
(Travel, Physical Demand, Mental Demand)
Physical Demand:Light physical effort. For example, standing, bending, or stooping for extended periods, operating light office equipment, e.g., personal computer, copier, fax machine, etc., manually handling medium weight materials and/or equipment (0 to 10 pounds).
Mental Demand:Moderate to high degree of concentration due to volume, complexity, and/or “pressure” of work.
Xerox is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, sex, marital status, sexual orientation, physical or mental disability, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply or compete for employment with Xerox may request such accommodation(s) by sending an e-mail to email@example.com. Be sure to include your name, the job you are interested in, and the accommodation you are seeking.
Job: Service Delivery Healthcare
Organization: Workmans Comp Site
Title: Provider Relations Specialist
Requisition ID: 16031431
Virtual/work from home? No