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Telephone Representative II
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Full-time
- Research and request documentation for provider enrollment, credentialing and provider file updates
- Research and provide schedule of allowance for procedure codes and prior authorization requirements; research check reconciliation of claim payments
- Create call tracking records in call tracking system (QNXT) to the appropriate call tracking folders for resolution; mail printed materials upon request
- Verify provider inquiry using Knowledge Tool (BeneFAQs, QNXT, DocFind, iObserver)
- Retrieve and review scanned claim images using IRIS System
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