Customer Service Representative

Job description

Join Provider Resources (PRI) and Make an Impact in Healthcare!
At PRI, we're passionate about driving integrity and advancing quality across the healthcare system. As a trusted leader in the industry, we're tackling some of healthcare's biggest challenges-improving compliance, advancing health equity, and enhancing quality and clinical outcomes while helping organizations improve care delivery and create meaningful change.
We believe that people are at the heart of healthcare, and focus on scalable, person-centered strategies that prioritize clinical excellence and evidence-based practices. Our work supports a broad network of stakeholders, including providers, patients, caregivers, payers, and regulators. We strive to enhance experiences, improve outcomes, and foster a healthier future for all.
If you're looking to be part of a forward-thinking team that makes a difference, PRI is the place for you!
Job Title: Customer Service Representative
Position Description:
Reporting to the Independent Dispute Resolution Entity (IDRE) Stakeholder Engagement Subject Matter Expert, the Customer Service Representative (CSR) shall be in contact with Initiating Party and Non-initiating party stakeholders. The CSR shall be primarily responsible for efficiently answering inquiries telephonically and via email. The CSR shall record requests, collaborate with team members regarding inquiries, triage urgent requests or concerns and provide follow-up of inquiries to ensure stakeholders concerns are efficiently and effectively prioritized. The IDRE CSR is responsible for escalating matters to the IDRE Stakeholder Engagement SME. The IDRE CSR documents inquiries and provides reporting to trend inquiries. Outcomes of documentation may be used for continuous quality improvement initiatives.
Key Responsibilities:
- Efficiently answer inquiries via phone and email.
- Record and triage requests, collaborate with team members, and provide follow-up.
- Escalate matters to the IDRE Stakeholder Engagement SME as needed.
- Document inquiries and provide trend reports for continuous quality improvement.
- Maintain a communications log and participate in quality assurance activities.
Requirements:
- Associate's Degree or 4 years of related experience.
- Ability to work in a high-volume, high-pressure call center.
- Familiarity with CPT, ICD-9-CM, and HCPCS codes.
- Experience with IDR, No Surprises Act, or health insurance customer service preferred.
- Strong time management and organizational skills.
- Proficiency in Microsoft Word, Excel, and Access.
- Excellent communication skills, both verbal and written.
EEO Statement:
Provider Resources, LLC is an Equal Opportunity Employer. We do not discriminate against qualified applicants based upon any protected group status, including but not limited to race, religion, color, creed, sex (including breastfeeding and related conditions), gender identity/gender expression, pregnancy (including childbirth and related conditions), national origin, ancestry, age, marital status, military or veteran status, sexual orientation, genetic information, physical or mental disability or medical condition as defined by applicable equal opportunity laws. Any request for accommodation can be directed to Human Resources.
Benefits and Compensation
Provider Resources provides a competitive benefits package that includes access to Medical, Dental, and Vision Insurance, Life Insurance, Disability, Health Savings Account (HSA), Flexible Spending Accounts (FSA), Critical Illness, Accident, Legal and ID Theft, 401k plan, PTO.
The anticipated salary range for fully qualified candidates applying for this role will be $31,000 - $37,000 (not including discretionary bonus, equity, and benefits). The final salary offered will be dependent on several factors that include but are not limited to relevant previous experience including duration and type of experience within the industry, education, and internal equity.
HUBZone Preference: Preference will be given to individuals who reside in, or are willing to relocate to, a recognized HUBZone area. For more information, visit Go to www.sba.gov/hubzone for more information.

About PROVIDER RESOURCES INC

Join Provider Resources (PRI) and Make an Impact in Healthcare!
At PRI, we're passionate about driving integrity and advancing quality across the healthcare system. As a trusted leader in the industry, we're tackling some of healthcare's biggest challenges-improving compliance, advancing health equity, and enhancing quality and clinical outcomes while helping organizations improve care delivery and create meaningful change.
We believe that people are at the heart of healthcare, and focus on scalable, person-centered strategies that prioritize clinical excellence and evidence-based practices. Our work supports a broad network of stakeholders, including providers, patients, caregivers, payers, and regulators. We strive to enhance experiences, improve outcomes, and foster a healthier future for all.
If you're looking to be part of a forward-thinking team that makes a difference, PRI is the place for you!