Provider Relations Specialist (On-Site)

The OccuNet Company; Amarillo (TX); On-site; USD 50,000 - 70,000; Full time

Benefits offered by this job

401(k) with matching

Health insurance

Vision insurance

Health savings account

Paid time off

Job summary

The OccuNet Company is looking for a Provider Relations Specialist in Amarillo, Texas. The role involves collaborating with medical providers to address billing inquiries and disputes. Candidates should have strong communication and organizational skills, with an understanding of medical claims and cost containment products.

This full-time position offers a Monday to Friday schedule from 8 am to 5 pm CST, alongside benefits such as health insurance and 401(k) matching.

Qualifications

• Strong understanding of medical cost containment, medical claims, and general medical insurance.
• Excellent communication and interpersonal skills.
• Strong computer skills and ability to learn new systems.

Responsibilities

• Evaluate and respond to billing disputes from medical providers.
• Identify issues and determine required actions based on research.
• Ensure compliance with HIPAA laws and maintain confidentiality.

Skills

Communication skills

Time management

Microsoft Office proficiency

Understanding of medical cost containment products

Investigative mindset

Job description

Job Title

Provider Relations Specialist

Job Summary

As the Provider Relations Specialist, you will collaborate with medical providers and clients to resolve billing inquiries and disputes.

Duties & Responsibilities

• Evaluate and respond to disputes from medical providers regarding claim processing and/or billing.
• Identify the issue at hand and determine the actions required to resolve the matter based on independent research and sound judgment.
• Follow up with medical providers as needed to ensure agreed upon actions are carried out (i.e., balance adjustments).
• Obtain new or missing documentation from medical providers and/or clients to ensure successful processing of medical bills.
• Respond to routine help desk inquiries from medical providers and clients, including status updates and pricing questions.
• Collaborate with internal colleagues to ensure consistent messaging and solution delivery for all clients and medical providers.
• Diligently adhere to all HIPAA laws, rules, and regulations.
• Maintain confidentiality of sensitive information.
• Perform other duties as assigned.

Required Skills and Abilities

• Strong understanding of medical cost containment products including but not limited to reference-based pricing, out-of-network, and pharmacy benefits manager solutions.
• Knowledge in medical claims including CPT and ICD 10 coding, billing, or general medical insurance preferred.
• Excellent communication and interpersonal skills, written and verbal, with the ability to adapt appropriately for different audiences.
• Excellent time management and organizational skills.
• Able to multi-task effectively, transition between tasks frequently, and maintain focus when presented with interruptions.
• Strong computer skills, with a working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook, OneNote) and comfortability learning and navigating new systems.
• Investigative mindset, with the ability and drive to conduct independent research as needed.
• Adaptable to change.
• Team-first mindset with a high level of motivation, drive, and a desire to learn.
• Passionate and proactive about contributing to organizational missions with an emphasis on improving client and medical provider experiences.
• Strong attention to detail.
• Persistent and motivated to find a solution.
• Comfortable working in a fast-paced environment.
• Prolonged periods sitting or standing at a desk and working on a computer.

Schedule

Full‑time, Monday to Friday 8 am – 5 pm CST.

Benefits

• 401(k) with matching
• Health insurance
• Vision insurance
• Health savings account
• Paid time off