Provider Support Representative

Provider Support Representative

Provider Support Representatives are responsible for addressing complex issues that affect healthcare providers and the individuals they serve. This role involves direct communication with providers and collaboration across internal teams to deliver timely, accurate resolutions while maintaining exceptional service standards. The representative plays a key role in ensuring a positive experience for members seeking care by identifying and removing barriers to access and satisfaction. Strong organizational skills and proactive communication are essential for managing workload and resolving challenges effectively.

Primary Duties and Responsibilities

• Outbound calls and email inquiries from providers.
• Manage assigned cases and workflow through efficient use of internal systems.
• Investigate, troubleshoot, and resolve issues within established service-level agreements (SLAs).
• Collaborate with team members and leadership to identify trends and address recurring challenges.
• Utilize internal tools and resources to support accurate and timely resolutions.
• Communicate outcomes and next steps clearly to providers and relevant internal teams.

Skills and Requirements

• Minimum of 1 year in a customer support or service role in a healthcare environment
• Strong computer proficiency, including experience with CRM platforms and knowledge management systems for issue resolution.
• Familiarity with ticketing systems and reporting tools.
• Proven ability to manage and prioritize a caseload effectively.