New

Provider Relations Associate Analyst

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Apr 28, 2026
Title: Provider Relations Associate Analyst Location: 100% Remote Duration: 6 Months Candidate Questionnaire (Mandatory - Please Answer While Applying) Please include your responses to the questions below in your application: Do you have a Bachelor's Degree in Behavioral Health? If yes, please specify your degree and specialization. What kind of experience/exposure do you have in the behavioral health field? (Mention role, responsibilities, and duration) What kind of customer service experience do you have? (Call handling, support roles, tools used, etc.) If the opportunity were to present itself, would you be interested in a full-time position in the future? Work Schedule Training Hours: Monday - Friday, 8:30 AM - 5:00 PM CST (first ~18 weeks) Post-Training Hours: 10:30 AM - 7:00 PM CST Preference for candidates in PST, MST, and CST time zones (EST considered for strong candidates) Position Overview The Claims & Provider Relations (PR) Advocate is responsible for handling inbound calls from members, providers, and their office staff regarding claims and provider-related inquiries. This role requires strong communication, multitasking, and problem-solving skills to ensure accurate resolutions and excellent customer service. This is a fully remote/work-from-home position. Candidates must have a reliable high-speed internet connection (not provided). Equipment will be supplied. Key Responsibilities Handle inbound calls related to: Claim status and processing details Claim reprocessing requests Provider contract inquiries Demographic updates Make outbound calls as needed for follow-ups and issue resolution Assist members/providers with: Understanding claim outcomes Billing protocols and processes Authorization corrections Requesting duplicate EOBs Payment-related issues (check reissue, stop payment, etc.) Submit requests for claim adjustments and escalations Send communications and resources via email Collaborate with internal teams for complex issue resolution Maintain professionalism and deliver first-call resolution whenever possible Work across multiple systems and applications simultaneously Required Skills Strong customer service experience Excellent communication and interpersonal skills Ability to work effectively in a remote/virtual environment Strong multitasking and organizational abilities Proficiency with multiple systems and technical tools Effective problem-solving skills Strong time management and attention to detail Good typing speed and solid PC skills Training Initial training will focus on Eligibility & Benefits calls (Behavioral Health Providers) Additional training on Claims and Provider Relations will be provided based on business needs Attendance expectations are strict, especially during the first 90 days. Education Requirement Bachelor's Degree required