Provider Services Advocate
About The Position
The Provider Services Advocate plays a critical role in supporting healthcare providers by serving as a liaison between providers and the health care organization. This position ensures that providers receive timely assistance with inquiries, claims, and service issues, ultimately enhancing provider satisfaction and operational efficiency. The advocate will analyze provider concerns, coordinate with internal departments, and facilitate resolutions to complex problems. By maintaining strong relationships and clear communication channels, the role contributes to the seamless delivery of healthcare services. The ultimate goal is to foster a collaborative environment that supports providers in delivering high-quality patient care.
Requirements
- High school diploma or equivalent
- Experience in call center environment
- Knowledge of automated systems (technical adeptness) required.
- Demonstrated proficiency in Microsoft programs (i.e., Excel, Word, PowerPoint) required.
Nice To Haves
- Associate’s or Bachelor’s degree in healthcare administration or related field preferred.
- Experience working with Medicaid, Medicare, or commercial insurance providers.
- Experience processing UB04 and CMS 1500 claims
- Familiarity with healthcare regulatory requirements and compliance standards.
- Certification in healthcare customer service or provider relations.
- Demonstrated ability to use data analytics tools to identify trends and support decision-making.
Responsibilities
- Serve as the primary point of contact for healthcare providers seeking assistance with claims, billing, credentialing, and service-related inquiries.
- Investigate and resolve provider issues by collaborating with internal teams such as claims processing, credentialing, and customer service.
- Maintain accurate records of provider interactions, issues, and resolutions to ensure accountability and continuous improvement.
- Communicate policy updates, procedural changes, and relevant information to providers to keep them informed and compliant.
- Identify trends in provider concerns and recommend process improvements to enhance provider experience and operational workflows.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
