Provider Relations Assistant
Rising Medical Solutions, Inc - Chicago, IL

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Role : Provider Relations Assistant

Department : Specialty Services

Location: Chicago, IL

Employment Status: Hourly (non-exempt)

Reason

To facilitate the smooth and speedy flow of information between Rising, its Bill Review clients, and healthcare providers through timely and dependable administrative support.

Responsibilities

  • Handle intake of incoming reconsiderations through multiple sources and media (mail, fax, e-mail, hard copy).
  • Scan incoming reconsiderations into the bill review system. Assess and identify rush requests (state or legal disputes, client requests) and route them appropriately for priority completion.
  • Track and ensure closure of all priority reconsiderations via the bill review and issues management systems.
  • Maintain reports to track team productivity, turnaround time, reconsideration volume and aging via the issues management system, on-line reporting system, and Excel.
  • Handle outgoing reconsiderations to both clients and providers according to client-specific instructions, including all overnight or priority outgoing mail for Provider Relations/Specialty Bill Review.
  • Coordinate responses to all subpoena requests and other administrative tasks related to litigation.
  • Maintain and purge archived reconsideration files.
  • Scan bills, medical records, and negotiated agreements into the bill review system as appropriate.
  • Assist clients and providers with telephonic inquiries regarding reconsiderations, EOR requests, etc.
  • Provide general administrative support for Specialty Services/Large Medical Bill Audit as needed.
  • Participate in ongoing training to enhance job skills and knowledge.
  • Other duties may be assigned based on company needs.


  • Relationships
    • Reports to: Provider Relations Manager
    • Regularly interacts with other members of the Specialty Services department and other Rising employees (Medical Review Unit, TechOps, Professional Services, IT, etc.).
    • Occasionally interacts with medical service providers/vendors and Rising clients.

    Requirements

    Education/Training
    • High School Diploma or equivalent required
    • Bachelor Degree preferred
    Experience
    • Previous medical bill review experience a plus
    • Previous mail handling and/or scanning experience a plus
    • Prior experience with Microsoft Windows and Office applications (Word, Excel, etc.) required
    Skills/Competencies
    • Meticulous attention to detail
    • Scanning and computer skills, particularly file maintenance and Microsoft Outlook
    • Patience to perform routine functions on a daily basis
    • Proven customer service skills
    • Ability to work independently and as part of a team
    • Highly organized and focused
    • Ability to distinguish between different types of medical bills (e.g. HCFA vs. UB-92)
    • Basic mathematical aptitude (addition, subtraction, multiplication, division)
    • A desire to continue to learn and improve both self and the organization
    • A professional presence

    Reward
    • Compensation commensurate with skills and experience.
    • Competitive benefits package.
    • Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future.
    • Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
    • Daily interaction with some of the most talented people in the medical cost-containment industry.

    RISING Overview

    Headquartered in Chicago, Illinois and founded in 1999, RISING Medical Solutions, Inc. is a national medical cost containment and care management firm which services the workers’ compensation, auto, and liability markets. The Company is one of the fastest growing private enterprises in America, as ranked by Inc. magazine and the Private Company Index (PCI). Its positive culture and strong core values have been written about in various magazines and publications, including a business textbook used in graduate programs across the country.

    Rising Medical Solutions, Inc - 15 months ago - save job - block
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    About this company
    Headquartered in Chicago, Illinois, Rising (http://www.risingms.com) is a leading medical-financial solutions organization that services the...