About the Role
Responsible for providing
advanced customer service
representation for accounts.
Primary duties may include
but are not limited to:
-Supporting provider training
through ongoing review and
proactive identification of
issues like claims submission
errors.
-Monitoring established VBP
arrangements that reward
providers.
-Providing the necessary
support for providers to
provide quality, cost-effective
care that results in increased
satisfaction and engagement.
-Assisting providers in
decreasing administrative
burdens by deploying
technology solutions like
online claims and prior
authorization submission
tools.
-Identifying systemic or
provider-level claims
adjudication errors through
predictive analytics.
-Providing guidance and
support to providers in
identifying claims denials and
trends, participating in
provider survey, state onsite
visits, participating in IHCP
workshops as well as town hall
meetings.
Requirements
 Requires a BA/BS; 3 years of related experience; or any combination of education and experience, which would provide an equivalent background. Travel may be required.
About the Company
RepuCare, a healthcare solutions agency, is currently seeking an Account Service Coordinator for a large managed care client.