Health Provider Relation representative

Job Title: Health Provider Relation representative

Duration: 6+ month

Pay: $18

Location: Fully remote (candidates anywhere in the U.S., with PST or MST preferred for late shifts)

Work Environment:

• Fully remote/work-from-home position.
• Training Schedule: 8:30 AM – 5:00 PM CST (Monday-Friday).
• Post-training Schedule: 10:30 AM – 7:00 PM CST.

Education:

• Bachelor’s degree required.

Role Overview:

The Provider Relations Associate Analyst will primarily handle inbound calls related to claims and provider relations. Responsibilities include resolving claim inquiries, assisting with provider contract questions, and demographic updates. This position requires strong customer service skills, technical proficiency, multitasking ability, and independent problem-solving.

Responsibilities:

• Handle inbound calls from members and providers, answering questions about claim status, billing, and provider relations.
• Educate members and providers on claims processing and billing protocols.
• Adjust claims, write or correct authorizations, and request reprocessing as needed.
• Make outbound calls when necessary to resolve issues or follow-up.
• Assist providers with contract-related inquiries and demographic updates.
• Provide resources via email and submit complaints or handoff requests as needed.
• Ensure accurate information and first-call resolution.

Skills and Qualifications:

• Required: Bachelor’s degree.
• Skills:
• Customer service experience.
• Excellent communication and interpersonal skills.
• Problem-solving and time management.
• Strong PC skills and proficiency in multiple claim systems.
• Independent, self-driven, and professional.
• Additional Skills: Organizational skills, excellent listening ability, and strong multitasking capabilities.