Provider Relations Specialist

DescriptionThis person will be on the bill review team specifically working in the backlog of appeals. The Provider Relations Rep is similar to the Bill Review, but more focused on provider outreach to complete bill processing. The position holds accountability for accurate and timely review, processing and payment of bills to include pre-coding accuracy and adjudication of appeals/provider reconsideration requests. Would prefer them to have worked in Mitchell Smart Advisor platform which is the largest workers comp program but open to similar programs as well.Additional Skills & Qualifications Examines and adjudicates requests for appeals, reconsiderations, re-evaluations, and corrected bills. Maintains knowledge of industry standard medical coding initiatives and state specific fee schedules and coding guidelines Meets or exceeds department contractual and/or industry standards for accuracy and turnaround time Maintains an understanding of all variations of Workers’ Compensation state rules and regulations Maintains comprehensive knowledge of all available re-pricing opportunities (e.g. PPOs, direct contracts, etc.), ensures application as part of the adjudication process Monitors itemized billings for excessive charges, duplications, and appropriate medical bills coding Reviews/processes appeals and initiates refund requests, assists in the recoupment process. Assists in the preparation of bills research reportsExperience LevelExpert Level#eastpriority25 Pay and BenefitsThe pay range for this position is $25.00 - $25.00/hr.Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)Workplace TypeThis is a hybrid position in Tampa,FL.Application DeadlineThis position is anticipated to close on Feb 12, 2025.About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.