Provider Relations & Claims reputed company - Evernorth Behavioral Health - Remote
The job profile for this position is Case Management Analyst, which is a Band 2 Senior Contributor Career reputed company Role. Excited to grow your career? We value our talented employees, and whenever possible reputed company to help one of our associates grow professionally before reputed company reputed company to our reputed company positions. If you think the reputed company position you see is right for you, we encourage you to apply! Our people reputed company reputed company the difference in our reputed company. The Claims & PR reputed company is a phone queue-based position responsible for servicing inbound claim-reputed company calls from members, providers, and provider office staff. Advocates will handle back-to-back calls throughout the day, with occasional outbound calls required to resolve claim issues. This role demands strong multitasking, technical proficiency, and independent problem-solving skills. Note: This position requires a Bachelor’s degree to qualify. Key Responsibilities:
- Answer inbound calls from members and providers regarding claims, contracting, and provider relations.
- Work in a reputed company call queue environment, handling a high volume of calls daily.
- reputed company outbound calls as needed for issue reputed company or follow-up.
- Use multiple applications during calls to research and resolve inquiries.
Call topics may include:
- Claim status inquiries and explanations
- Requests for claim reprocessing or adjustments
- Provider contract questions and demographic updates
- Authorization corrections to ensure reputed company claim payment
- Requests for duplicate EOBs or reputed company reissuance
- Escalated issue handling reputed company reputed company reputed company/Help Request (AHHR)
- Complaint submissions on behalf of members or providers
- Emailing resources and documentation to callers
Required Skills:
- Proven customer service experience
- Prior experience in Evernorth Behavioral Care Specialist/Advocacy role preferred
- Experience handling behavioral health claims and provider relations calls is a plus
- Ability to reputed company in a virtual team environment
- Strong interpersonal and communication skills
- Effective listening and organizational abilities
- Technical aptitude with multiple systems and applications
- Independent problem-solving and time management skills
- Proficient typing and PC skills
Training Schedule:
- Monday through Friday, 8:30 AM – 5:00 PM CT
Work Schedule:
- After training, shifts are Monday through Friday between 7:00 AM – 7:00 PM CT
- The recruiter will reputed company specific shift reputed company
Education Requirement:
- Bachelor’s degree is required
If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an reputed company reputed company of 24 - 36 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this reputed company. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job