Provider Payment & Cost Analysis Specialist

Midwest Startups; United States; Hybrid; USD 65,000 - 90,000; Full time

Job summary

Midwest Startups is seeking a detail-oriented Provider Payment Specialist to support the operational and financial processes within our self-funded health program. You will obtain good faith estimates, analyze costs across in-network and cash-based providers, and generate member cash cards.

You will collaborate with nurse navigators to provide cost information, ensure invoice accuracy, educate members on documentation, and help optimize provider payment workflows for affordability and

Qualifications

• 2+ years in healthcare operations, provider billing or revenue cycle.
• Strong analytical skills to compare costs and pricing options.
• High attention to detail and accuracy in reviewing invoices and documentation.
• Strong written and verbal communication skills.
• Ability to explain payment processes to members and providers.

Responsibilities

• Obtain good faith estimates for scheduled services.
• Perform cost analyses for in-network and cash-based providers.
• Generate cash cards for members.
• Educate members on documentation and receipt submission.
• Provide cost information to nurse navigators and operational teams.
• Support pricing and payment options across care/navigation teams.
• Review provider invoices for accuracy and alignment with pricing.
• Investigate and resolve invoice discrepancies with providers and internal stakeholders.
• Maintain documentation of estimates, invoices, receipts, and payments.
• Contribute to process improvements across provider payment operations.

Skills

Good faith estimates

Cost analysis

Provider billing

Excel

Google Sheets

Communication

Analytical

Tools

Excel

Google Sheets

Job description

Midwest Startups is seeking a detail-oriented Provider Payment Specialist to support the operational and financial processes within our self-funded health program. You will obtain good faith estimates, analyze costs across in-network and cash-based providers, and generate member cash cards.

You will collaborate with nurse navigators to provide cost information, ensure invoice accuracy, educate members on documentation, and help optimize provider payment workflows for affordability and