Position Title: Provider Relations Associate Analyst
Work Location: Remote
Assignment Duration: 4+ Months
Work Arrangement: Remote

Position Summary:
The Claims & PR (Provider Relations) Advocate will service inbound claim calls from both members and providers or their office support staff. Occasional outbound calls are required to resolve claim issues.

Background & Context:
This is a fully remote, work-from-home position. The Organization will supply all equipment; however, a reliable high-speed internet connection is required.

Key Responsibilities:

• Answer inbound claim calls from members or providers, as well as contracting and Provider Relations related calls from providers

• Work in a structured environment with the majority of the day spent servicing calls from a queue

• Make occasional outbound calls for issue resolution and follow-up

• Assist members or providers with understanding how a claim has processed

• Verify claim status for members or providers

• Educate members or providers on billing protocols

• Write or correct authorizations to ensure claims are paid correctly

• Send claims for adjustment or reprocessing

• Request duplicate EOBs for members or providers

• Send requests for cancelled check copies, reissued checks, or stop-pay requests

• Provide follow-up by making outbound calls when necessary

• Send resources to members and providers via email

• Submit complaints on behalf of members or providers

• Send handoff requests to matrix partners for escalated or complex issues

• Assist providers with contract-related inquiries and demographic updates

• Independently problem-solve to ensure accurate information, exceptional customer service, and first-call resolution

Qualification & Experience:

• Customer service experience

• Ability to excel in a virtual team environment

• Ability to maintain a professional and positive image

• Superb interpersonal communication skills

• Effective listening and organizational skills

• Ability to manage multiple tasks

• Strong technical aptitude and ability to learn multiple systems

• Independent problem-solving skills

• Strong time management skills

• Ability to type effectively with strong PC skills

• Bachelor’s degree required

• No certifications or licenses required

Working Conditions & Physical Demands:

• Fully remote, work-from-home environment

• High-speed internet required

• Structured schedule with strict attendance expectations

Additional Information:

• Training schedule: Monday–Friday, 9:30am–6:00pm CST

• Post-training schedule: Monday–Friday, 10:30am–7:00pm CST

• Attendance is closely monitored with a formal corrective action process

 

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 21.23/hr.