Provider Support Specialist

At NationsBenefits, we are committed to helping health plan members achieve a better quality of life through supplemental benefit solutions. We are also passionate about supporting the goals of our associates and helping them do their best work. Together, we can make a meaningful and measurable difference in the lives of millions. That’s something we can all be proud of.

It all begins with how we care about the people we serve. Since 2015, our mission has guided our principles toward delivering solutions for a rapidly changing industry. Compassionate Care is at the center of all we do, and it unites us to foster an environment where everyone is empowered, inspired, and equipped for success.

We offer a fulfilling work environment that attracts top talent and encourages all associates to do their part in delivering premier service to internal and external customers alike. It’s how we’re transforming the healthcare industry for the better. We provide career advancement opportunities within the organization with multiple locations in Florida, California, Pennsylvania, Tennessee, Texas, Utah, and India.

You might also like to know that NationsBenefits is also recognized as one of the fastest-growing companies in America. We’re proud of how far we’ve come, and a career with us also gives you growth opportunities.

Role

The purpose of the Provider Relations Specialist is to provide exceptional customer service by supporting our Provider Network Team and responding to provider inquiries. Provider Relations Specialists answer provider inquiries regarding the network enrollment process, provider reimbursement fees, network status, referral process, etc. These duties include researching, documenting, and communicating with providers involved in a grievance case, supporting the claims department with improper claims, initiating recognition campaigns, etc.

Responsibilities

• Support, develop, and maintain service relationships with all members of the provider network.
• Respond to electronic and direct inquiries from providers about policies, rates, changes, referrals, eligibility, payments, credentialing, etc.
• Work closely with other Provider Network team members to ensure Provider data, status, and inquiries are accurate and being properly addressed.
• Provide responsive and professional customer service to providers on inbound/outbound calls, email, and fax communications.
  
• Collaborate with and support the Compliance department with any Provider-related issues, including member grievances.
• Research, track, and communicate Provider complaints related to quality of service, facility conditions, improper sales, and incomplete or inaccurate information.
• Work with team members and the Manager to identify process improvements.
• Utilize necessary resources and navigate systems efficiently to verify and provide accurate information to provider’s inquiries accurately.
• Support Provider contracting activities to ensure efficiency and accuracy.

Qualifications

• High School Diploma or Equivalent, a College Degree is a plus!
• 1- 2 years of experience in customer service
• Ability to handle high call volumes and make sound business decisions in an efficient manner
  
• Experience and interest in Healthcare Insurance/Medicare is a plus
• PC proficiency required, basic Microsoft Applications and Web applications
• Excellent listening and interpersonal skills
• Excellent communications skills
• Multi-task oriented
• Attention to detail and quality-oriented
• Analytical thinker and problem solver

Preferred Skills

• Healthcare or related industry experience preferred
• Call Center experience preferred
• Knowledge of consultative sales techniques
• Ability to remain highly motivated in a multi-faceted environment

Work Schedule

Training starts Monday 10/16

• Mon - Fri 9 am - 5:30 pm

NationsBenefits is an Equal Opportunity Employer.

Salary : $16 - $0