Carisk Partners

General

• Serve as a primary point of contact for healthcare providers regarding reimbursement inquiries, billing questions, and payment-related concerns
• Develop and maintain productive working relationships with hospitals, physician offices, ambulatory surgery centers, and ancillary providers
• Respond to provider inquiries in a timely, professional, and customer-focused manner
• Research and resolve provider questions related to bill review determinations, payment calculations, reductions, and reimbursement methodologies
• Assist in resolving provider disputes, appeals, reconsideration requests, and escalated reimbursement issues
• Communicate payment determination rationale to providers clearly and professionally
• Coordinate with bill review, coding, clinical, legal, and operations teams to facilitate issue resolution
• Maintain knowledge of applicable workers' compensation regulations, fee schedules, and reimbursement requirements
• Support internal compliance initiatives and audit activities as requested
• Document provider interactions, inquiries, and resolutions within designated systems
• Maintain accurate records of provider disputes, escalations, and communication activities
• Participate in process improvement initiatives to enhance provider experience and operational efficiency

Provider Relations Specialist

Analyst

• Develop and maintain enterprise-wide commercial dashboards and performance scorecards
• Analyze sales performance against targets, quotas, and strategic objectives
• Provide region, territory, and individual market-level performance analysis
• Identify trends, risks, and opportunities impacting commercial growth
• Leverage AI and automation to improve analysis of multiple data points
• Manage Total Addressable Market analysis and pipeline prioritization
• Identify growth opportunities through TAM assessments, market penetration analysis, cross-sell and upsell opportunities, and margin optimization evaluations
• Partner with sales leadership to prioritize high-value opportunities and target accounts
• Maintain and analyze network partner data, including geographic coverage and market intelligence
• Serve as primary analytics contact for client reporting requests and deliverables
• Establish standards for data definitions, data mapping, reporting methodologies, and user access governance
• Review reporting accuracy, consistency, and scalability
• Partner with IT and operations to improve reporting processes and data quality
• Evaluate client-facing self-service reporting opportunities
• Support commercial leaders with performance reporting and business insights
• Establish and monitor key performance indicators by line of business
• Identify negative trends, volume shifts, and market risks requiring intervention
• Evaluate operational performance metrics such as turnaround times versus goals and across clients
• Support annual planning, forecasting, and growth strategy initiatives
• Provide analytics support for client stewardship meetings and executive business reviews
• Develop data-driven client presentations and growth strategies with Client Management and Marketing
• Deliver executive-level reporting packages and presentation materials
• Serve as analytics liaison during prospect pitches and client meetings
• Provide insight into Marketing ROI and spend optimization
• Develop or administer tools for Marketing activity and outcome measurement

Provider Relations Specialist

Commercial Analyst