Provider Support Specialist

Health Partners Plans, Inc.; Jefferson Center (PA); On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Benefits package

Job summary

Health Partners Plans, Inc. is seeking a Provider Services Agent to support our provider network through call-center based service, acting as a liaison to ensure providers receive timely assistance and accurate information.

This role requires strong communication, problem-solving, and customer service skills, with the ability to navigate multiple systems in a fast-paced environment. The position contributes to operational excellence and provider satisfaction, with ongoing training and

Qualifications

• High School Diploma/GED or 3 years of equivalent work experience.
• 2 years of inbound call center experience.
• Strong organizational, analytical, communication, and interpersonal skills with the ability to manage multiple priorities.
• Proficiency in Microsoft Office applications and the ability to navigate multiple systems, databases, and applications with accuracy.
• Demonstrated problem-solving and customer service skills, including de-escalation.

Responsibilities

• Serve as a primary point of contact for providers, delivering accurate, professional, and timely support regarding eligibility, benefits, authorizations, claims status, network participation, and plan policies.
• Investigate and resolve provider inquiries by reviewing claims, researching issues, coordinating with internal departments, and escalating as needed for effective resolution.
• Educate providers on Jefferson Health Plans processes, programs, and self-service tools, including Provider Portal capabilities.
• Accurately document provider interactions and maintain compliance with procedures, standards, and documentation requirements.
• Manage inbound/outbound communications while adhering to information security and cross-functional protocols.
• Meet established performance, productivity, and quality standards and participate in training.
• Contribute to provider experience by supporting initiatives, staying current with plan guidelines, and performing related duties.

Skills

Call center experience

Communication skills

Organization

Problem solving

Microsoft Office

Education

High School Diploma/GED

Tools

HRP

EPIC

Salesforce

HealthTrio

eCIS

Job description

Health Partners Plans, Inc. is seeking a Provider Services Agent to support our provider network through call-center based service, acting as a liaison to ensure providers receive timely assistance and accurate information.

This role requires strong communication, problem-solving, and customer service skills, with the ability to navigate multiple systems in a fast-paced environment. The position contributes to operational excellence and provider satisfaction, with ongoing training and