Provider Service Representative

Martin's Point Health Care Inc.; New York (NY); Remote; USD 28,000 - 34,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Retirement plan

Paid time off

Pie day

Other employee benefits

Job summary

Martin's Point Health Care is seeking a Provider Service Representative I for a fully remote role, with a start date of November 9, 2026. You will professionally respond to telephone inquiries from providers and related entities about benefits, eligibility, plan coverage, enrollment, claims adjudication, billing, and payments for USFHP and Medicare programs.

Responsibilities include delivering accurate information, following up on resolutions, collaborating with other departments, documenting

Qualifications

• High school diploma or equivalent.
• 3 years of customer service experience.

Responsibilities

• Answers verbal, written and electronic inquiries with complete and accurate information and educates when possible regarding Martin’s Point USFHP and Medicare program’s policies, procedures and self‑service options.
• Responds to incoming inquiries and partners with provider on possible next steps and or resolution.
• This should be completed within the timeframes outlined in Representative Expectations document.
• Collaborates with PI Research team and or other departments when needed to resolve Provider issues.
• Follows up in a timely manner with providers when first call resolution is not possible.
• Stays educated on existing and new information available through Provider Services internal resources.
• Documents all provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry.
• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.

Skills

Excellent customer service

Analytical skills

Strong computer skills

Active listener

Detail oriented

Independent work

Education

High school diploma or equivalent

Job description

Company Culture

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of \"people caring for people,\" Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a \"Great Place to Work\" since 2015.

Position Summary

This is a fully remote position, and we are looking for someone who is available to start on November 9, 2026. The Provider Service Representative I is responsible for professionally responding to telephone inquiries from providers and related entities. Inquiries may include, but are not limited to, benefits, eligibility, plan coverage, enrollment status, claims adjudication, billing, and payments for Martin’s Point USFHP and Medicare programs.

Job Description

• Answers verbal, written and electronic inquiries with complete and accurate information and educates when possible regarding Martin’s Point USFHP and Medicare program’s policies, procedures and self- service options.


• Responds to incoming inquiries and partners with provider on possible next steps and or resolution.


• This should be completed within the timeframes outlined in Representative Expectations document.


• Collaborates with PI Research team and or other departments when needed to resolve Provider issues.


• Follows up in a timely manner with providers when first call resolution is not possible.


• Stays educated on existing and new information available through Provider Services internal resources.


• Documents all provider inquiries with accurate and detailed information according to correct template, including the resolution and next steps of the inquiry.


• Uses soft skills to build trusting relationships in the context of mutual partnership creating a world class service experience for internal and external customers.

Education & Experience

• High school diploma or equivalent.


• 3years of customer service experience.

Requirements

• Terms of employment may require the applicant/incumbent to qualify, obtain and maintain a Position Level of Trustworthiness from the U.S. Government Office of Personnel Management.


• Additionally, this position may require the applicant/incumbent to be a U.S. citizen.

Skills/Knowledge/Competencies (Behaviors)

• Demonstrates an understanding of and alignment with Martin’s Point Values.


• Excellent customer service skills


• Previous experience in a medical billing position preferred.


• Ability to work efficiently and independently.


• Analytical skills in research and problem resolution.


• Strong computer skills (keyboard proficient, quick data entry with a high level of accuracy).


• Ability to talk and type.


• Active Listener


• Able to work cooperatively with other departments.


• Multi-task oriented with the ability to prioritize.


• Detail oriented.


• Well organized with excellent follow up skills.


• Ability to handle stressful situations and can easily adapt to change.

There are additional competencies linked to individual contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

Pay Range

Pay Range: $20.20 - $24.95 The pay range above reflects the anticipated base pay range based on a full-time position. Actual compensation will be determined based on factors such as experience, skills, qualifications, and other job-related considerations. Employees may also be eligible for additional compensation, including incentive or commission-based programs, where applicable and subject to the terms of the relevant plan.

Benefits

In addition to base compensation, we offer a comprehensive benefits package including

• medical


• dental


• vision


• retirement savings with employer contributions


• paid time off (including volunteer time off!)


• pie day


• other employee benefits

Immigration

This position is not eligible for immigration sponsorship.

Equal Opportunity

We are an equal opportunity/affirmative action employer.

Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities.

If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact [e-mail]

Do you have a question about careers at Martin’s Point Health Care? Contact us at: [e-mail]

Martin’s Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin’s Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in Maine, New Hampshire, Vermont, upstate New York, northern and western Pennsylvania, and northeastern and central Ohio). For more information, visit https://careers.martinspoint.org.