Clinical Services Representative I or II
This position supports PEHPs efforts to mitigate the rising cost of health care and provide excellent customer service.
This position performs a variety of support duties including clinical services technical support customer service support and education through inbound and outbound communications.
This position also collaborates with PEHP nurses pharmacists and doctors provides customer service to PEHP members and network physicians solves problems with preauthorizations or claims and assists the Clinical Management department in preauthorization evaluation and the disputedappealed preauthorization process.
The successful candidate will have excellent communication skills a basic understanding of medical terminology understand medical claims payments the ability to learn and apply new information and is willing to go the extra mile to provide excellent customer service.
The incumbent must always demonstrate good judgment high integrity and personal values consistent with the values of URS.
Clinical Services Representative I Grade NonExempt ESSENTIAL JOB FUNCTIONS AND DUTIES Clinical Services Representative II Grade NonExempt ESSENTIAL JOB FUNCTIONS AND DUTIES Clinical Services Representative I High School diploma and two years of progressively responsible experience in a medical setting insurance practice facility etc.
or an equivalent combination of education and experience.
Certification as a Nursing Assistant CNA Medical Assistant AAMA Current Procedural Terminology CPT registered pharmacy technician CPhT or other health care related licensecertificate is preferred.
Certified Professional Coder CPC or medical terminology certification and or specific experience in claims processing computer software applications and electronic billing procedures is preferred Clinical Services Representative II Education and Experience High School diploma and three years of progressively responsible experience in a medical setting insurance practice facility etc.
or an equivalent combination of education and experience.
Certification as a Nursing Assistant CNA Medical Assistant AAMA Current Procedural Terminology CPT registered pharmacy technician CPhT or other health care related licensecertificate is preferred.
Certified Professional Coder CPC or medical terminology certification and or specific experience in claims processing computer software applications and electronic billing procedures is preferred.
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Estimated Salary: $20 to $28 per hour based on qualifications.
This position performs a variety of support duties including clinical services technical support customer service support and education through inbound and outbound communications.
This position also collaborates with PEHP nurses pharmacists and doctors provides customer service to PEHP members and network physicians solves problems with preauthorizations or claims and assists the Clinical Management department in preauthorization evaluation and the disputedappealed preauthorization process.
The successful candidate will have excellent communication skills a basic understanding of medical terminology understand medical claims payments the ability to learn and apply new information and is willing to go the extra mile to provide excellent customer service.
The incumbent must always demonstrate good judgment high integrity and personal values consistent with the values of URS.
Clinical Services Representative I Grade NonExempt ESSENTIAL JOB FUNCTIONS AND DUTIES Clinical Services Representative II Grade NonExempt ESSENTIAL JOB FUNCTIONS AND DUTIES Clinical Services Representative I High School diploma and two years of progressively responsible experience in a medical setting insurance practice facility etc.
or an equivalent combination of education and experience.
Certification as a Nursing Assistant CNA Medical Assistant AAMA Current Procedural Terminology CPT registered pharmacy technician CPhT or other health care related licensecertificate is preferred.
Certified Professional Coder CPC or medical terminology certification and or specific experience in claims processing computer software applications and electronic billing procedures is preferred Clinical Services Representative II Education and Experience High School diploma and three years of progressively responsible experience in a medical setting insurance practice facility etc.
or an equivalent combination of education and experience.
Certification as a Nursing Assistant CNA Medical Assistant AAMA Current Procedural Terminology CPT registered pharmacy technician CPhT or other health care related licensecertificate is preferred.
Certified Professional Coder CPC or medical terminology certification and or specific experience in claims processing computer software applications and electronic billing procedures is preferred.
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Estimated Salary: $20 to $28 per hour based on qualifications.
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