Provider Service Specialist

About the Role

This is a temporary/seasonal remote opportunity through April 2027. The schedule is Monday through Friday, 8:00 AM – 4:30 PM EST. Experience with Medicare Advantage, managed care, health insurance, customer service, or call centers is helpful.

The Provider Service Specialist responds to provider inquiries—via phone, in person, or in writing—regarding plan benefits, services, and payment determinations in a timely and accurate manner.

Responsibilities

• Receive, interpret, and accurately respond to provider inquiries verbally and in writing following department standards, policies, and procedures.
• Consistently document and code all inquiries within designated software applications, adhering to required timeframes and documentation policies.
• Review, investigate, and advise providers on claims status and payment determinations.
• Document and track actions requested from other departments to address provider or member inquiries and informal complaints, ensuring prompt resolutions.
• Interact professionally, efficiently, and effectively with providers, management, and other departments in a caring and respectful manner.

Requirements

• High School diploma or equivalent required.
• 2–3 years of prior customer service experience required.
• Effective communication skills.

Benefits

• Competitive compensation and benefits packages, including medical, dental, and vision coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition and professional development reimbursement starting on day one.
• 100% paid RN to BSN tuition at Mount Carmel’s College of Nursing.
• Relocation assistance (geographic and position restrictions apply).
• Employee Referral Rewards program.
• Access to DailyPay—see earnings daily and transfer funds before payday.
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Mount Carmel Health System was recognized by Forbes in 2025 as one of America’s Best State Employers.

Schedule

Monday through Friday, 8:00 AM – 4:30 PM EST.