*Here's an exciting career opportunity to become a part of one of the best places to work. We are looking for more smart, talented, passionate, loyal, and fun-loving individuals to become "Lucent Health" - the face, the voice, and the behavior that represents the quality of who we are to those we serve!*

**Provider Relations Representative Job Description**

**Role Summary**

The primary focus of the Provider Relations Representative is to answer provider inquiries regarding verification of benefits and claims status for medical and dental claims; entering precertifications into the claims processing system, working miscellaneous claims queues, sending out correspondence, outbound provider call projects, and reviewing claims spreadsheets and plan documents.

**Daily role responsibilities:**

* Works collaboratively with claims administration for Lucent Health client groups.

* Provide responsive and professional customer service to providers regarding status of medical and dental claims.

* Utilize necessary resources and navigate systems efficiently to accurately verify eligibility and provide verification of benefits.

* Assist providers in getting set up and utilizing Provider Portal

* Maintain a positive and professional attitude.

* Work with members of staff on identifying process improvements

* Perform other duties as assigned by management.

* Report to work on a consistent, regular basis during core business hours (8:00 a.m. 5:00 p.m.).

**This position could be a good fit if you have:**

* 1-2 years previous Health/Dental Insurance experience or experience in medical and dental terminology, coding, and/or claims processing preferred.

* Thorough understanding of Self-Funding Insurance and Third-Party Administrating concepts.

* Strong organizational skills, problem solving, and decision-making skills required.

* Ability to navigate through and utilize 25 PC applications efficiently. Knowledge in Excel and Word.

* Self-direction and self-starter skills required. Demonstrated written and oral communication skills required.

**Other Duties**

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

**Physical and Emotional Demands:**

While performing the duties of this job, the employee is frequently required to sit. The employee is regularly required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus.

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**Equal Employment Opportunity Policy Statement**

Lucent Health Solutions, Inc. is an Equal Opportunity Employer.