Provider Support Specialist
Core
Managing claims status inquiries, resolving billing issues, and supporting provider advocacy for a specialty care platform.
Role type
Claims and Provider Support Specialist
Builds
Operational solutions for billing accuracy and provider relationships
Domain
Healthcare / Insurance Claims
Deliverable
client delivery
Required skills
Claims management, billing investigation, trend analysis, root cause documentation, data entry, provider communication
Preferred skills
Empathy, process improvement, relationship management
Technologies
CareHub, SharePoint
Responsibilities
Manage low- and high-complexity claims status inquiries, including appeals and internal requests; Investigate and resolve member billing issues, ensuring accuracy and compliance; Maintain accurate documentation in CareHub and SharePoint; Audit member bill payment requests and ensure proper documentation for supervisor approval; Track and report trends in billing errors to support process improvement; Participate in provider advocacy outreach and relationship management efforts; Conduct trend analysis and document root causes of provider support inquiries