Provider service rep, answered calls, gave benefit info. Set up cases, Took pharmacy calls, Checked on claims , sent them back ,if not denied correct
Provider Services Representative (Current Employee) – Schenectady, NY – October 27, 2013
Must be on phones at 8:30 am . Calls start coming in , Providers are calling ,to ck on claims, pharmacy, set up inpt cases. for admissions\ck benefits, ck eligibility, we work off of many different programs. Try to take calls as efficiently as possible. Some calls may be as long as a hour or so. When you check on claims, appeals and denials. Also sending remits ,and denial letters to Providers. We must follow all Hippa laws.
We have two 10 min breaks, a day 30 min for lunch. If you take a last call @ 4:30 , you need to stay on call until complete, could take a very long time .
The hardest part of the job, is that everything keeps changing every day. Each person handles call coaching differently, so you get a lot of mixed messages.
The most enjoyable part, is when you are on with a provider,You get all the information, and solve a problem , that is going on for a long time.
Most co workers are very nice, some never speak to you, You be respectable to every one .
Management is ok, We have a very nice supervisor and manager now.They are very good, but follow every bit of procedure, there is no give and take. Also ,the rules are the rules. Except for the favorites.
I follow the rules , I give 110% every day. Try my best, Sometimes , very hard place to stay positive.
we get a free lunch once a month for stats being good, very nice
so many people leaving the company, either on there own or being let go, because of mistakes, or being out to much. lots of people left on there own, due to the fact, they keep addding more and more to the job, with 22 reps not there anymore.