Provider Relations Associate Analyst

HireTalent; BLOOMINGTON (MN); Remote; USD 40,000 - 60,000; Full time

Job summary

A leading company is seeking a Claims & PR Advocate to service inbound calls related to eligibility and benefits from behavioral health providers. This fully remote position requires strong customer service and technical capabilities, with a focus on resolving claims inquiries and providing excellent support to members and providers. Successful candidates will demonstrate effective multitasking, problem-solving skills, and maintain a professional demeanor throughout their interactions.

Qualifications

• Customer service experience, preferably in a virtual team environment.
• Professional demeanor and excellent interpersonal skills.
• Technical aptitude for quickly learning multiple claim systems.

Responsibilities

• Answer inbound claims and provider calls, including some outbound follow-up.
• Assist members and providers with claim processing, status verification, billing, and authorizations.
• Independently resolve issues to ensure accuracy and first-call resolution.

Skills

Customer service experience

Interpersonal skills

Listening

Organization

Multitasking

Problem-solving

Time management

PC skills

Job description

Please see attached qualifying questions prior to submitting candidates.

Note: this position is fully remote / work from home. Candidates must be willing to complete all training and work from their home. Evernorth will supply all equipment; however, high-speed internet is required.

Candidates must have a reliable high-speed internet connection at home — this will NOT be provided. Manager seeking candidates located anywhere in the U.S. — candidates in PST or MST are ideal for staffing our late shift.

Training hours are 8:30am-5:00pm CST. After training, hours will be 10:30am-7:00pm CST.

Contractors will initially be trained to handle calls regarding Eligibility and Benefits from Behavioral Health Providers. Training for Claim and Provider Relations (PR) calls will follow, based on business needs.

Job Description and Role Summary

The Claims & PR Advocate services inbound calls from members and providers, including occasional outbound follow-up. Calls may include inquiries about claim status, reprocessing requests, provider questions, or demographic updates. Multiple applications are often used during calls, requiring technical savvy, multitasking, and problem-solving skills. Calls must be handled professionally and helpfully.

Responsibilities

• Answer inbound claims and provider calls, including some outbound follow-up.
• Assist members and providers with claim processing, status verification, billing, authorizations, and adjustments.
• Handle requests for duplicate EOBs, check reissues, and stop payments.
• Follow up on issues, escalate when necessary, and communicate via email.
• Support provider contract inquiries and demographic updates.
• Independently resolve issues to ensure accuracy and first-call resolution.

Qualifications

• Customer service experience, preferably in a virtual team environment.
• Professional demeanor and excellent interpersonal skills.
• Effective listening, organization, and multitasking abilities.
• Technical aptitude for quickly learning multiple claim systems.
• Strong problem-solving, time management, and PC skills.

Training & Work Schedule

Training: Monday-Friday, 8:30 AM - 5:00 PM CST.

Post-training hours: 10:30 AM - 7:00 PM CST.

Attendance Policy

Attendance is crucial. Unapproved absences or events in the first 90 days may lead to verbal counseling, notices, or termination. Tardiness and early departures without notification are tracked and may impact employment, with exceptions at supervisor discretion. Excessive attendance issues may accelerate corrective actions.