Provider Service Representative

Tabula Rasa Healthcare Saint Louis , MO 63150

Posted 2 months ago

Peak Health Plan Management Services offers PACE third party back-office solutions, including claims processing, billing and health plan management solutions, along with over a decade of serving PACE/LIFE programs throughout the United States. Peak Health Plan Management Services operates as a service of Capstone Performance Systems, a subsidiary of Tabula Rasa HealthCare.

Under the supervision of the Client Service Manager, the Provider Service Representative is responsible for answering calls from our clients? medical provider network and providing timely and accurate responses in a professional and courteous manner. This position also assists with various internal tasks that ensure a high level of overall client satisfaction.

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Essential Functions:

  • Responds to provider phone inquiries in a timely manner; provides accurate responses in a professional and courteous manner

  • Researches inquiries using appropriate team members as a resource

  • Follows up with providers as needed to relay claim status or obtain further information

  • Assists team with providing claim status for client inquiries

  • Ensures that HIPAA guidelines are followed in every communication with providers, clients or staff

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Additional Functions:

  • Assists with special projects, as requested

  • Communicates clearly and concisely, with sensitivity to the needs of others

  • Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employees

  • Maintains courteous, helpful and professional behavior on the job; displays a willingness and ability to be responsive in a warm and caring manner to all customer groups. Consistently cooperates and supports organization in problem solving issues.

  • Establishes and maintains effective working relationships with co-workers

  • Follows all Policies and Procedures and HIPAA regulations

  • Participates in any recommended or required training sessions

  • Maintains a safe working environment

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Supervisory Responsibility: None

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Travel: Minimal travel, less than 10%, expected for this position


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Provider Service Representative

Tabula Rasa Healthcare