Provider Relations Specialist

Carisk Partners

. Serve as a primary point of contact for healthcare providers regarding reimbursement inquiries, billing questions, and payment-related concerns .

Posted 10/3/2026full-timeUnited StatesJuniorMid-Level💰 $19 - $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in healthcare reimbursement processes, provider relations, and conflict resolution while maintaining compliance with workers' compensation regulations. Proficient in managing provider inquiries and enhancing operational efficiency through effective communication and relationship management.

Highest-signal resume keywords

Healthcare ReimbursementProvider RelationsConflict ResolutionMicrosoft Office SuiteWorkers' Compensation Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingClaims ManagementBill ReviewPayment IntegrityAnalytical CapabilitiesReimbursement MethodologiesProvider DatabasesReporting SystemsProcess ImprovementAttention to Detail

Soft Skills

Customer ServiceRelationship ManagementVerbal CommunicationWritten CommunicationProblem-Solving

Tools & Technologies

Microsoft ExcelMicrosoft WordMicrosoft OutlookMicrosoft TeamsReimbursement Platforms

Industry Keywords

Healthcare AdministrationBilling QuestionsPayment-Related ConcernsProvider InquiriesDispute ResolutionEscalated Reimbursement IssuesFee Schedules

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Finance, Nursing, or a related field preferred
Equivalent work experience may be substituted for formal education
2 to 5 years of experience in workers' compensation, healthcare reimbursement, provider relations, medical billing, claim operations, payment integrity, or bill review
Experience interacting with healthcare providers and resolving reimbursement-related issues preferred
Strong customer service and relationship management skills
Excellent verbal and written communication abilities
Effective conflict resolution and problem-solving skills
Strong attention to detail and analytical capabilities
Ability to manage multiple priorities and meet deadlines
Ability to communicate complex reimbursement concepts clearly and professionally
Microsoft Office Suite, including Excel, Word, Outlook, and Teams
Claims management, bill review, or reimbursement platforms
Experience with provider databases and reporting systems preferred
Knowledge of applicable workers' compensation regulations, fee schedules, and reimbursement requirements

Benefits

Comp & perks

10 Paid Company Holidays
Paid Time Off
Competitive Medical, Dental, and Vision Insurance
Company Sponsored Life Insurance
Supplemental Life Insurance
Short/Long Term Disability
Employee Assistance Program
Flexible Spending Account
401(k) Retirement Plan with Company Match
ClassPass Wellness Program
Employee Discount Program
Flexible and Hybrid Schedule Options
Internal Education Programs and Tuition Reimbursement Options
Internal Advancement Opportunities
Company-Wide Diversity and Holiday Celebrations