OxfordRecruiter Since 2001
the smart solution for Oxford jobs

Customer Service Representative- Managed Care, FT, Days

Company: North Mississippi Medical Center
Location: Tupelo
Posted on: January 9, 2022

Job Description:

Essential FunctionsList major areas of responsibility and briefly what the person does in each area. Customer Service for CVO:

  • Assist with researching claim issues brought forward from clinic administrators and customer service staff.
  • Regularly monitor claim denial reports to further investigate payer panel roster errors.Database Accountability
    • Assists ITS in the development and maintenance of the CVO intranet page and Health Link web site
    • Assist with the entering and maintaining accurate provider data in the system wide credentialing database.
    • Assist with the validation of provider data in the credentialing database with clinic administratorsReporting:
      • Provides routine reporting for all NMHS affiliated providers, Health Link, and Connected Care Partners provider panels, including monthly dashboard reports for Management, routine trend analysis, and ad hoc reporting, as requested
      • Maintains delegated provider rosters for payers, including both governmental and commerical third party payersContracting Support:
        • Expertise in all of credentialing, including EDI, provider recertification and enrollment, Medicare, Medicaid, and commercial insurance
        • Experience in preparing and filing insurance provider agreements
        • Follows through on all process details until contract completionRegulation:
          • Adheres to NMHS/NMMC Policies/Procedures/Guidelines
          • Complies with applicable Local/State/Federal policies/procedures/guidelines

            Job Knowledge:
            • Bachelor degree preferred; multiple years of NMHS system and/or healthcare system experience considered
            • Previous customer service required
            • Basic credentialing/privileging knowledge; required
            • Excellent communication (written and verbal) skills; required
              • Working knowledge of Microsoft software (i.e. Word, Excel, Outlook); required
              • Strong interpersonal skills; required
                recblid g9xsjj828zeq9c7of7jtndxpqzgglg

Keywords: North Mississippi Medical Center, Oxford , Customer Service Representative- Managed Care, FT, Days, Sales , Tupelo, Mississippi

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Mississippi jobs by following @recnetMS on Twitter!

Oxford RSS job feeds