Access Provider Services Specialist (Full-Time, Remote)

About the role

The ACCESS Provider Services Specialist provides high-quality customer support to healthcare providers by handling inquiries related to claims, contracts, authorizations, benefits, services, and community resources. They assist with provider onboarding, educate on available resources, authenticate providers, and route calls to appropriate departments to ensure first call resolution.

Responsibilities

• Respond to provider inquiries via phone, providing information on services, resources, and processes.
• Perform initial triage to determine caller needs and connect them to the correct department or resources.
• Document all interactions accurately within electronic systems and update materials as needed.
• Assist with specialized projects and departmental reviews upon request.
• Serve as a subject matter expert on provider support operations.

Qualifications

• Bachelor’s degree in Human Services or related field with 2+ years of experience working with individuals with psychiatric, chemical dependence, or developmental disabilities, OR 4+ years of relevant experience.
• Knowledge of Medicaid waivers, mental health, substance use, and developmental disability services.
• Qualified Professional status per state regulations.

Skills

• Strong interpersonal, communication, problem-solving, negotiation, and conflict resolution skills.
• Ability to manage multiple priorities, adapt to changing needs, and work independently with discretion.

Requirements

• Access to confidential healthcare information and adherence to related laws, including HIPAA.
• Proficiency in handling complex provider network issues and understanding of healthcare policies.
• Physical ability to perform tasks including reading, typing, and limited physical activity.

This is a remote position requiring residency within North Carolina or within 40 miles of the border.

Schedule

Monday through Friday.