Provider Services Representative

Description

Collabrios delivers purpose-built software solutions that unify the entire care journey. With decades of expertise in Programs of All-Inclusive Care for the Elderly (PACE) and deep industry knowledge, we empower care providers to streamline operations and deliver exceptional care to aging adults. Our integrated SaaS platform includes Electronic Medical Records (EMR), Third-Party Administrator (TPA) financial services, and care coordination solutions, helping PACE programs optimize workflows, ensure compliance, and enhance overall operations.

We partner with PACE, government agencies, and community-based organizations to advance care delivery and improve outcomes for the communities they serve.

Job Overview

We are seeking a dedicated and detail-oriented Provider Services Representative to support our provider network by resolving inquiries related to claims, payments, system access, and policies. This is a client-facing, high-volume call center role where you’ll serve as a key point of contact for providers, ensuring accuracy, efficiency, and a positive experience.

Key Responsibilities

• Provider Communication: Respond to high-volume provider inquiries about claims, payments, access, and policies with clear, professional, and empathetic communication.
• Claims Research & Resolution: Investigate and resolve issues related to claim status, payment discrepancies, coding, and eligibility. Partner with internal teams to ensure timely and accurate resolution.
• CRM & Systems Management: Accurately document provider interactions in CRM platforms and manage workflows through internal systems.
• Provider Support & Education: Help providers navigate claims processes, documentation requirements, and Collabrios systems. Identify common questions or concerns and suggest improvements to educational resources.
• Process & Policy Training: Participate in training on evolving systems, processes, and compliance requirements. Support new team members by sharing best practices.
• Quality Assurance & Compliance: Ensure all actions comply with HIPAA and internal standards. Contribute to quality improvement by identifying process gaps and recommending solutions.
  
  

Requirements

What You Bring

• High school diploma or equivalent required
• 2 years of experience in healthcare, insurance, or a TPA environment, preferably in a provider service or claims role
• Understanding of Medicare, Medicaid, and PACE programs
• Working knowledge of medical claims processing and healthcare terminology
• Proficiency with CRM or ticketing systems (e.g., Jira, Salesforce) and Microsoft Office Suite
• Clear and professional verbal and written communication skills
• Strong analytical, problem-solving, and organizational skills
• Ability to manage multiple priorities in a fast-paced, deadline-driven environment
• Familiarity with HIPAA and healthcare compliance standards
• Self-starter who takes initiative and follows through on tasks
• Experience contributing to process documentation or policy development is a plus
  
  

What We Offer

At Collabrios Health, we’re committed to fostering a workplace that supports your well-being, growth, and ability to make a meaningful impact. Here’s what you can expect when you join our team:

• A connected, virtual-first culture with a collaborative, mission-driven team
• Competitive health benefits, including medical, dental, and vision coverage
• 401(k) with company contribution
• Flexible paid time off (PTO), plus 72 hours of sick time
• Flexibility and trust—we empower our team to manage their schedules and work in ways that support their lives
• Opportunities for learning, mentorship, and professional development
• A values-driven environment where diverse perspectives are welcomed and purpose guides our work
  
  

We’re committed to building a diverse and inclusive workplace.

Collabrios is an equal opportunity employer. We welcome candidates from all backgrounds, identities, and experiences. If you’re excited about this role but your experience doesn’t align perfectly with every qualification, we encourage you to apply anyway. You may be the right candidate for this or other roles.