Provider Validation Specialist

OpsArmy

. Research healthcare providers and identify appropriate custodians for different types of medical records and billing documents .

Posted 10/2/2026full-timeRemote • PhilippinesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong research and information-verification skills, with a focus on maintaining accurate and complete medical records. Proficient in analyzing multiple sources to identify discrepancies and ensure compliance with HIPAA authorization requirements.

Highest-signal resume keywords

Researching Healthcare ProvidersInformation VerificationHIPAA Authorization RequirementsMedical Billing KnowledgeOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Records ManagementData EntryRecord RetrievalDocumentationAnalysis of Medical RecordsNPI LookupsClaim Form ProcessingEOB AnalysisRelease of Information (ROI)Health Information Management (HIM)

Soft Skills

Attention to DetailProblem-SolvingStrong Written CommunicationOrganizational SkillsIndependent Work

Tools & Technologies

Healthcare System WebsitesVendor PortalsDatabasesOnline PortalsFax and Email Communication

Industry Keywords

Medical BillingUB-04CMS-1500Explanation of Benefits (EOB)Legal SupportHealthcare Information Vendors

About the role

Key responsibilities & impact

Research healthcare providers and identify appropriate custodians for different types of medical records and billing documents
Confirm whether requests must be submitted by fax, email, online portal, or mail
Document exact submission details, contact information, attention lines, and provider-specific requirements
Determine when requests need to be separated by record type, custodian, or date of service
Ensure authorization documents and request packets meet provider-specific requirements
Research existing records before adding new entries and maintain accurate, complete, and duplicate-free provider information
Use databases, healthcare system websites, provider resources, NPI information, vendor portals, and other reliable sources to verify details
Conduct phone verification when required
Investigate rejected or delayed requests, make corrections, and escalate issues when necessary
Document research findings, submission requirements, provider information, and updates for other team members

Requirements

What you’ll need

Excellent written English with strong attention to detail
Strong research and information-verification skills
Ability to analyze multiple sources and identify accurate information
Strong organizational and documentation skills
Ability to identify discrepancies, missing information, and duplicate records
Comfortable working independently and following established processes
Strong problem-solving and follow-up skills
Ability to work a schedule that overlaps with U.S. Eastern Time business hours
Shortlisted candidates may be asked to complete a timed skills assessment independently and without the use of AI tools
Understanding basic HIPAA authorization requirements
Prior medical records experience is not required
Preferred experience in researching healthcare providers, facilities, or billing entities
Preferred experience with Release of Information (ROI), Health Information Management (HIM), medical billing, UB-04 or CMS-1500 claim forms, NPI lookups and verification, Explanation of Benefits (EOBs), legal support, medical records retrieval or release processes, and record-release or healthcare information vendors

Benefits

Comp & perks

Full-time remote work
Opportunity to develop experience in healthcare information and medical records processes
Opportunities for advancement into senior validation, provider data, quality, or team leadership roles
A collaborative, fast-paced work environment focused on accuracy and continuous improvement