Provider Network Support Specialist

Job Summary

To support provider data management, the full-time Provider Network Support Specialist will perform day-to-day tasks ensuring accurate provider setup in the information system, assist with claims payment resolution, and maintain provider directories in a remote work environment.

Key responsibilities

• Provide support to external provider representatives to resolve data issues and respond to provider-related inquiries
• Initiate and process provider add, change, and termination forms while maintaining accurate provider directories
• Research claim payment inaccuracies and collaborate with cross-functional teams to facilitate provider education and orientations

Required qualifications

• Associate's degree preferred, along with claims processing, billing, or coding experience
• Five or more years of experience in a managed care environment or healthcare organization
• Knowledge of healthcare, managed care, Medicare, or Medicaid
• Experience in customer service within a medical provider office
• Familiarity with provider data management and network reporting