Provider Relations Associate Analyst

Title: Provider Relations Associate Analyst

Location: 100% Remote

Duration: 6 Months

Candidate Questionnaire (Mandatory - Please Answer While Applying) Please include your responses to the questions below in your application:

1. Do you have a Bachelor's Degree in Behavioral Health?
   
   
   
   • If yes, please specify your degree and specialization.
   
   
   
   
2. What kind of experience/exposure do you have in the behavioral health field?
   
   
   
   • (Mention role, responsibilities, and duration)
   
   
   
   
3. What kind of customer service experience do you have?
   
   
   
   • (Call handling, support roles, tools used, etc.)
   
   
   
   
4. If the opportunity were to present itself, would you be interested in a full-time position in the future?

Work Schedule

• Training: Monday - Friday from 8:30am - 5:00pm CST After Training: Monday - Friday from 10:30am - 7:00pm CST

Position Overview The Claims & Provider Relations (PR) Advocate is responsible for handling inbound calls from members, providers, and their office staff regarding claims and provider-related inquiries. This role requires strong communication, multitasking, and problem-solving skills to ensure accurate resolutions and excellent customer service.

This is a fully remote/work-from-home position. Candidates must have a reliable high-speed internet connection (not provided). Equipment will be supplied.

Key Responsibilities

• Handle inbound calls related to:
  
  
  
  • Claim status and processing details
  • Claim reprocessing requests
  • Provider contract inquiries
  • Demographic updates
  
  
  
  
• Make outbound calls as needed for follow-ups and issue resolution
• Assist members/providers with:
  
  
  
  • Understanding claim outcomes
  • Billing protocols and processes
  • Authorization corrections
  • Requesting duplicate EOBs
  • Payment-related issues (check reissue, stop payment, etc.)
  
  
  
  
• Submit requests for claim adjustments and escalations
• Send communications and resources via email
• Collaborate with internal teams for complex issue resolution
• Maintain professionalism and deliver first-call resolution whenever possible
• Work across multiple systems and applications simultaneously

Required Skills

• Strong customer service experience
• Excellent communication and interpersonal skills
• Ability to work effectively in a remote/virtual environment
• Strong multitasking and organizational abilities
• Proficiency with multiple systems and technical tools
• Effective problem-solving skills
• Strong time management and attention to detail
• Good typing speed and solid PC skills

Training

• Initial training will focus on Eligibility & Benefits calls (Behavioral Health Providers)
• Additional training on Claims and Provider Relations will be provided based on business needs

Attendance expectations are strict, especially during the first 90 days.

Education Requirement

• Bachelor's Degree required