Provider Specialist Job

PROVIDER SPECIALIST needed for a CONTRACT opportunity with Yoh's client located in San Mateo, CA.

TOP SKILLS YOU SHOULD POSSESS:

- Claims Experience
- Managed Care Experience

WHAT YOU'LL BE DOING:

- Reporting to the Claims Director
- Review and resolve provider disputes for all lines of business for contracted as well as non-contracted providers in accordance with state and federal statutes, regulations, and program guidance
- Research issues; adjust claims, including computation of interest owed as appropriate
- Perform other duties as assigned

WHAT YOU NEED TO BRING TO THE TABLE:

- High School Diploma or Associates Degree preferred
- Claims Provider Services and Managed Care experience
- Working knowledge of CPT, HCPC, and Revenue Codes
- Medical claims processing and reimbursement experience preferred
- NCCI edits and MediCal experience is a plus
- Must have excellent writing, verbal, and customer service skills
- Proficient in Microsoft Office Applications and Computer

WHAT ARE YOU WAITING FOR? APPLY NOW!

RECRUITER: Annie Gill

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Contact us if you are an individual with a disability and require accommodation in the application process.

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