Provider Support Specialists

Russell Tobin's client, a multinational health insurance company, is hiring Provider Support Specialists in Lehi, UT

Apply Now!

Employment Type: Contract/Hybrid

Location: Lehi, UT Hybrid (Onsite twice a week)

Duration: 6+ months with possible extension or conversion

Pay range: $22/hr - $23/hr W2

Schedule: Mon – Fri

Job Description:

We are seeking a proactive, detail-oriented Provider Support Specialist Contractor to support the growth of our Provider Services team. In this role, you will serve as a key point of contact for healthcare providers and their staff, helping them navigate claims, benefits, and administrative processes efficiently.

You will play an important role in resolving complex provider inquiries, supporting operational workflows, and contributing to improvements in the overall provider experience through feedback and collaboration.

What You’ll Do

• Serve as a primary liaison between healthcare providers and the internal support team, delivering timely, accurate, and professional assistance via phone and provider portal messaging
• Build and maintain strong relationships with provider offices to support effective communication and long-term collaboration
• Investigate and resolve complex provider inquiries related to:
• Claims submission, status, and adjudication
• Benefit and plan interpretation
• Member cost-sharing and billing questions
• Prior authorizations and coordination of benefits
• Appeals and overpayment recoupment
• Verify and communicate patient eligibility, coverage details, and accumulator balances
• Accurately document all provider interactions within internal systems
• Collaborate cross-functionally with teams such as Claims, Product, and Network to resolve issues effectively
• Identify trends in provider issues and escalate systemic concerns for further investigation and resolution
• Contribute to the improvement of internal tools, workflows, and training documentation
• Educate providers on self-service tools and best practices to enhance efficiency and reduce administrative friction
• Meet or exceed established service level agreements (SLAs) for response and resolution times

What Success Looks Like

• Providers receive clear, accurate, and timely resolutions with minimal follow-up
• Consistent, high-quality documentation with strong attention to detail
• Ability to independently resolve complex or ambiguous provider inquiries
• Proactive identification of recurring issues and contributions to process improvements
• Positive feedback from both providers and internal stakeholders

Basic Qualifications

• 2+ years of experience in healthcare operations, provider support, or medical claims
• Strong understanding of claims adjudication, eligibility verification, and prior authorization processes
• Excellent written and verbal communication skills, with the ability to clearly explain complex information
• Highly organized with strong attention to detail and documentation accuracy
• Ability to manage multiple priorities in a fast-paced, high-volume environment
• Experience working independently in a remote or hybrid setting
• Familiarity with HIPAA regulations and patient confidentiality standards
• Strong problem-solving skills and ability to work through ambiguous situations

Preferred Qualifications

• Experience in provider-facing or B2B healthcare support roles
• Familiarity with clearinghouse platforms such as Availity, Zelis, or similar systems
• Experience with contact center systems or case management tools
• Understanding of common claim denial reasons and healthcare payment cycles
• Bachelor’s degree in Healthcare Administration or a related field (or equivalent experience)

Tools & Systems

Experience with, or ability to quickly learn:

• Provider portals and clearinghouses (e.g., Availity, Zelis)
• CRM or case management platforms
• Internal knowledge bases and documentation tools

Benefits that Russell Tobin offers:

Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.