Provider Inquiry Analyst

TRISTAR Insurance Group:

TRISTAR Insurance Group is a Third Party Administrator for Workers' Compensation claims management (www.tristarrisk.com). Founded in 1987, TRISTAR employs over 700 people with a wide-range of expertise. TRISTAR has over 20 offices nationwide.





Provider Inquiry Analyst**Positive Working Environment!** www.tristarrisk.comSummary: A Provider Inquiry Analyst requires a thorough knowledge of bill review rules, regulations and generally accepted billing practices. A Provider Inquiry Analyst is responsible for responding to inquiries either written or verbal regarding the method used for workers compensation reimbursement.

 

Competency:  

 

To perform the job successfully, an individual should demonstrate the following competencies:

 

Analytical –Consistently demonstrates common sense, logic and critical thinking to resolve problems.

 

Technical Skills –Must have thorough knowledge of the CA Official Medical Fee Schedule, comprehensive understanding of generally accepted billing practices in workers’ compensation, an understanding and familiarity with CPT, HCPC, DRG reimbursements and ICD-9 codes. In addition to CA, knowledge of workers’ compensation fee schedules for CO, TX, AZ, OR and UT preferred.

 

Customer Service - Responds promptly and appropriately to customer needs and provider inquiries.

 

Oral Communication - Speaks clearly, concisely and persuasively in all situations; responds appropriately to questions either verbally or in written form. 

 

Time Management – Effectively manages assigned tasks to meet strict department deadlines.

 

Qualifications: Successful job performance requires the knowledge, skill, and/or ability listed below.

 

Education and/or Experience:

 

Associate's degree (A. A.) or equivalent from two-year college or technical school plus three years of senior technical experience; or five to seven years related experience and/or training; or equivalent combination of education and experience.



Language Skills:  

 

Ability to read and interpret documents such as medical reports, legal documents including labor code and fee schedules.  Ability to effectively communicate verbally or in written form. 

 

Reasoning Ability:  

 

Ability to use commons sense, logic and critical thinking to solve practical or complex problems and handle a variety situations where only limited information exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. 

 



 

BENEFITS: 

We offer excellent coverage for Medical, Dental, and Vision, along with 17 days of paid time off, 8 days of paid holidays, 401k with company match, direct deposit, flextime, and more!

TO APPLY:

Please fax or e-mail resume in MSWord format to: (714)648-0796 or e-mail to: monica.cruz@tristargroup.net. EOE