Provider Relations Representative I

Job description

Overview Cotiviti, Inc. drives better healthcare outcomes through data analytics. This means taking in billions of clinical and financial data points, analyzing them, and then helping our clients discover ways they can improve efficiency and quality. Learn more at www.Cotiviti.com. Responsibilities: This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. - Initiates phone calls to customers, (providers/pharmacies/patients/carriers etc.) to confirm receipt of mailings, and to request action. - Provides timely response and resolution for all provider initiated inquires (phone calls, emails or faxes). - Reviews and analyzes documentation and claim data to determine validity and proper action. - Updates accounts receivable system with denial and group information. - Assists with high priority special projects. - Performs other functions as assigned. Qualifications: 2+ years’ experience as an examiner...