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SUMMARY:
Provider Relations Specialist I
Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.
Provider Relations Specialist II
Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.
PRIMARY RESPONSIBILITIES:
PRIMARY RESPONSIBILITIES: Provider Relations Specialist I
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