Provider Representative Cover Letter

Please consider me for the provider representative opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for support to Network Contracting, Product, Payment Integrity, Legal, Internal Audit, Revenue Program Management and other internal departments related to Florida Blue reimbursement methods, fee schedules, policies, and Medicare.

My experience is an excellent fit for the list of requirements in this job:

• Healthcare customer service experience preferred
• Services calls and correspondence from providers
• Reviews phone activity and quality reports to self-monitor performance, quality and productivity standards
• Demonstrated proficiency in provider reimbursement methods
• Track record of communicating effectively with all levels of an organization
• Basic knowledge of medical terminology/medications
• Self-motivated and self-starter who can work well under minimal supervision
• Knowledge of healthcare billing processes

I submit this application to express my sincere interest in the provider representative position.

In my previous role, I was responsible for training to the provider community on claim billing requirements and electronic claim submission software either in-person, via virtual classroom or by phone.

Please consider my experience and qualifications for this position:

• Able to recognize and utilize resources appropriately
• Able to share role specific content knowledge
• Job Role include members inquiring about current insurance coverage, previous insurance coverage, doctors in their programs, co-pays, claims questions
• Evaluate basis of their quality (as measured by the monitoring of recorded calls), their productivity, their accuracy of information and their attendance and punctuality
• Quality Customer Service
• Provides accurate information in a helpful, collaborative manner to callers through thorough knowledge of End Client products, policies and procedures
• Inquiries to be made primarily by telephone but also through written format (email, mail, fax, etc)
• Receives, resolves and routes complaints as defined by department policy, procedures and guidelines

In response to your job posting for provider representative, I am including this letter and my resume for your review.

In the previous role, I was responsible for client service function for managed care claims including clients, broker and/or internal departments and customers (Underwriting, Medical Risk, Accounting and Management).

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Demonstrates professionalism in communication, both verbal and written
• Experience in Credentialing or Provider Network Management
• Understands selling strategies, utilizing the behaviors on a daily basis
• Detailed understanding of ANSI X12 transactions including 270/271, 276, 278, 820, 835, and 837 transactions
• Experience in a customer service related role with high volume of transactions
• In depth understanding of Electronic Data Interchange (EDI)
• Knowledge of EDI testing tools such as Ramp Manager
• Advanced use of text editors

I submit this application to express my sincere interest in the provider representative position.

Previously, I was responsible for and updates relevant information on managed care operations to SPMF’s Network offices through The Hot Sheet.

My experience is an excellent fit for the list of requirements in this job:

• Proficient in a CRM system
• Strong problem solving/analytical skills, detail oriented
• Demonstrated experience working in a contact center environment, dealing with high-profile clients preferred
• A strong sense of service that drives all actions in the role
• Solid experience using Microsoft Word and intermediate level experience with Microsoft Excel is essential
• Solid experience using Microsoft Access or other database tools such as Visual Basic and Adobe
• Prior experience with web-based applications and data entry preferred
• Driven and dependable

In response to your job posting for provider representative, I am including this letter and my resume for your review.

In my previous role, I was responsible for timely and effective communication to other care providers to optimize patient care and our relationships with these other care providers.

My experience is an excellent fit for the list of requirements in this job:

• Interacts with other End Client staff to resolve customer inquiries, complaints and problems, particularly in Claims Services, Member Services, ILR / COB, Payment Processing, the Provider Processing Center, Provider Relations
• Provider Contracting, Medical Management, Benefits Administration, Pharmacy Services and the Behavioral Health and High-End Imaging vendors
• PSRs handles calls regarding claim status, appeal status, elibility and benefits, referral and authorizations
• Strong Medicare Provider Network background
• Strong Medicare Advantage PPO / HMO / Dual Special Needs (D-SNP, DSNP)
• Strong skills with Microsoft Excel, Powerpoint and Word
• Flexible with process changes
• Medical Claims exposure