10 provider relations specialist jobs found in Lansing, MI

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated Legal Specialist to join our team. We are looking for the right individual to join our team to assist our in-house attorneys in supervising claim files and undertaking related projects. The position requires the following, but is not limited to: Review and summarize complaints, claims files, medical records, employment files, and other documents. Assist with processes, workflows, tasks, diaries, and activities. Monitor and review laws and regulations. Assist with claims,...

SUMMARY:     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies. Trains and mentors other team members. Provides backup support to other...

Note: This position has a schedule requirement of 8pm shift end time on Mondays, the remainder of the week will be 5:30 shift end time. SUMMARY:  Primarily responsible for supporting the billing needs of agents and policyholders providing accurate and consistent services regarding invoice inquiries and premium transaction activity.  Approve changes in accordance with billing rules and procedures in compliance with Accident Fund and/or bureau rules and regulations. Contacts include Service Center staff, Finance Department, Premium Audit Department, Claims Department, agents, and policyholders. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.  •    Answers inquiries from agents and policyholders regarding invoices, disbursements, payments, and other billing transactions. •    Requests write offs to resolve small balance and NSF fee discrepancies within guidelines. •    Initiates, reviews, and approves disbursements. •    Reconciles and...

SUMMARY:  In addition to fulfilling the primary responsibilities of a Renewal Specialist, this role will also focus on serving as a lead worker in the Renewal Specialist department by assisting with quality, compliance and customer facing measures. Assisting staff with technical questions and provide mentoring to current and new staff. This role will also serve as a Subject Matter Expert, as well as participating in enterprise projects. Primarily responsible for assisting Business Development Consultants (BDCs) in growing and maintaining a profitable book of business and assists agents with inquiries related to underwriting rules, procedures, and regulations. Manages renewal book in accordance with the needs of the region they are aligned with. Mentors Renewal Specialists with complex agency/insured questions and policy information. Reviews policy structures to determine if changes need to be made to stay in compliance with bureau rules and regulations. Provides customer...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....

OBJECTIVE Associate P/C Customer Service Specialist Objective To work as a member of the Property/Casualty (P/C) Customer Service Team to provide exemplary customer experiences to policyholders and over 400 agents and their field office staff in a prompt, professional manner. To address policy and billing-related questions and concerns from internal and external customers on all personal and commercial lines of business via the telephone, e-mail, and website. To follow department standards of metrics tracked to ensure quality service. To preserve the Customer Service relationship, gather information and improve the overall service. RESPONSIBILITIES Associate P/C Customer Service Specialist Responsibilities Provide timely assistance to existing and potential policyholders, agents, and lienholders by addressing their inquiries about billing, insurance coverage questions and changes, and member benefits via answering telephone...

SUMMARY: (Brief 3-5 sentence paragraph outlining the main purpose of the job)     The Medical Only Claims Specialist I is an entry level claims role. The incumbent is expected to be proficient with the Claims unit, policies, processes, procedures, and terminology.      The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision.     Primarily responsible for the investigation and management of workers’ compensation claims. Conducts a 1 to 3-point contact on the managed claims, which is dependent on either the facts of the case or the claim type; determines compensability of claims, manages the medical treatment program, and assists in the return-to-work process. This includes calling and discussing potential claim activity and work-related injuries with policyholders, claimants, providers, attorneys, agents, and state agencies....