ACCESS Provider Services Specialist

Vaya Health

. Assist network providers with inquiries related to claims, contracts, authorizations, benefits, services, registries, and community resources .

Posted 9/30/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $42,000 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider support and call center operations, with a strong understanding of mental health services, Medicaid regulations, and the ability to manage confidential information. Exhibits exceptional communication, problem-solving, and organizational skills to effectively assist network providers and navigate complex inquiries.

Highest-signal resume keywords

Bachelor's Degree in Human ServicesQualified Professional CertificationKnowledge of Medicaid 1115 and WaiversExperience in Network ManagementInterpersonal and Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Call HandlingDocumentation of CallsTriage of Callers' NeedsProvider EducationConfidentiality Compliance

Soft Skills

DiplomacyDecision-MakingProblem SolvingNegotiationConflict Resolution

Certifications & Qualifications

Qualified Professional Certification

Industry Keywords

Mental Health ServicesCommunity Mental Health CenterBH I/DD Tailored PlanVaya PartnersHealthcare Information Compliance

About the role

Key responsibilities & impact

Assist network providers with inquiries related to claims, contracts, authorizations, benefits, services, registries, and community resources
Screen, handle, and route incoming phone calls, aiming for first-call resolution
Initiate outbound calls based on established work queues, lists, and assignments
Document all calls and routing activities through defined workflows and processes
Provide information and respond to providers’ inquiries, concerns, and questions by phone
Perform initial triage of callers’ needs and determine appropriate call handling
Educate providers about resources available through Provider Central
Provide navigation support for forms, training guides, and contracting information
Authenticate providers, identify needs, and connect callers to the appropriate One Touch workgroup
Serve as liaison between departments regarding questions, processes, and information resources
Update materials related to call center operations when assigned
Serve as a subject matter expert for Provider Support Line call center operations
Complete progress notes, forms, reports, and other required documentation at the time of the call and by the end of the workday or shift
Assist with specialized ACCESS Call Center departmental projects and reviews as requested by management
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree in a Human Services field and at least two years of experience working with adults or children with serious psychiatric, chemical dependence, or developmental disability in a community mental health center or similar setting; OR bachelor’s degree from an accredited college or university and at least four years of comparable experience
Must be qualified as a Qualified Professional according to 10A NCAC 27G .0104
Must reside in North Carolina or within 40 miles of the North Carolina border
Considerable knowledge of the MH/SU/DD service array provided through the network of Vaya Partners providers
Knowledge of Medicaid 1115, Medicaid B and C waivers, and Vaya Partners accreditation requirements
Understanding of BH I/DD Tailored Plan eligibility, services, policies, procedures, and Provider Manual requirements
Ability to handle confidential healthcare information and protected health information (PHI), comply with HIPAA and related confidentiality laws, complete required confidentiality training, and sign a confidentiality statement
High level of diplomacy and discretion
Exceptional interpersonal and communication skills
Prompt independent decision-making, problem solving, negotiation, arbitration, and conflict resolution skills
Ability to organize multiple tasks and priorities and manage projects from start to finish
Ability to adapt to changing priorities
Close visual acuity and ability to perform sedentary work, sit for extended periods, and lift up to 10 pounds
Preferred: 2+ years of experience in a network management-related role handling complex network providers in the health care industry

Benefits

Comp & perks

Monday–Friday work schedule, 9:30 am–6:00 pm
40-hour work week
Overtime compensation eligibility
Remote, home-based virtual position
Holiday rotation as required by the business