Provider Specialist

About the role

The Provider Specialist is responsible for troubleshooting issues, providing detailed information related to claims, coverage, and benefit plans, and ensuring provider concerns are resolved in a timely and efficient manner.

Responsibilities

• Verify provider credentialing for suspended claims
• Verify professional and facility pricing
• Maintain thorough and accurate documentation of all inquiries within designated tracking systems
• Apply a working knowledge of provider support systems

Requirements

• Bachelor’s degree in business, Health Care, or a related field/commensurate work experience
• In lieu of a BS/BA degree, extensive experience and knowledge of IBC’s various operating systems (3-5 years)
• In-depth knowledge of managed care and professional payment systems
• Demonstrated knowledge of various operational departments including Claims, Medical Policy, Contracting, Specialty Programs, Benefits, and Network Services

Qualifications

• Self-motivated, highly organized, detail-oriented, able to handle multiple high priorities
• Knowledgeable in problem solving, analytical, and communication skills (both written and verbal)
• Ability to interact with all levels of management

Skills

• Proficiency with Excel and Access
• Proficiency with Project (preferred)

Benefits

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Pay

Commensurate with experience

Schedule

TBD