Provider Engagement Specialist

Job Summary

To ensure accurate provider setup in the information system for state reporting and claims payment, the full-time Provider Engagement Specialist will work remotely, supporting external representatives, resolving provider data issues, and maintaining provider directories during Eastern Standard Time business hours.

Key responsibilities

• Provide support to external provider representatives to resolve data issues
• Research and respond to provider-related issues and process demographic changes
• Track, update, and audit provider data while facilitating provider education and orientations

Required qualifications

• Associate's degree preferred
• Three years of experience in a managed care environment or medical provider office
• Experience in customer service within a healthcare organization
• Knowledge of claims processing, billing, and/or coding
• Familiarity with Medicare or Medicaid systems