Provider Relations Specialist

Job Summary

To support provider services, the full-time Provider Relations Specialist will analyze call drivers, develop action plans to reduce provider contact rates, and collaborate with internal partners while enjoying the flexibility to telecommute from anywhere within the U.S.

Key responsibilities:

• Analyze data to identify call drivers and develop corresponding action plans
• Assist in driving process improvements to reduce provider contact rates across all lines of business
• Coordinate project implementation efforts and maintain documentation for assigned initiatives

Required qualifications:

• 2+ years of knowledge of line of business systems and Provider Service Operations processes
• 2+ years of experience with physician, ancillary, and facility claims, including submission and coding
• 1+ years of customer service experience with the ability to manage escalated calls
• 1+ years of experience educating providers on reimbursement policies and related claim issues
• Intermediate proficiency with PC-based software programs and automated database management systems