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About the Opportunity

Are you experienced in healthcare provider support, medical claims, or healthcare operations? Russell Tobin is hiring a Provider Support Specialist to support a growing Provider Services team in Lehi, UT.

In this role, you'll be a primary point of contact for healthcare providers and their staff, helping them navigate claims, benefits, eligibility, prior authorizations, billing, and other administrative processes. You'll investigate complex issues, work with internal teams to find solutions, and help improve the overall provider experience.

The ideal candidate has 2+ years of relevant healthcare experience, strong knowledge of healthcare claims and insurance processes, and the ability to independently resolve complex issues.

📍 Location: Lehi, UT (Hybrid – onsite at least 2 weekdays/week)

💰 Pay: $22.00–$23.00/hour

📅 Contract Opportunity with potential for permanent employment

Key Responsibilities

• Serve as a primary liaison for healthcare providers and their staff through phone and provider portal messaging.
• Build and maintain strong relationships with provider offices.
• Investigate and resolve inquiries related to claim submission, claim status, and adjudication.
• Assist with benefit and plan interpretation, member cost-sharing, and billing questions.
• Handle questions involving prior authorizations, coordination of benefits, appeals, and overpayment recoupment.
• Verify and communicate patient eligibility, coverage details, and accumulator balances.
• Accurately document all interactions, research, and resolutions in internal systems.
• Collaborate with Claims, Product, Network, and other teams to resolve provider issues.
• Identify trends and recurring issues and escalate systemic problems for root-cause analysis.
• Contribute to improvements in workflows, tools, training materials, and internal processes.
• Educate providers on self-service tools and best practices.
• Meet established SLAs for response and resolution times.

Qualifications

✅ 2+ years of experience in healthcare operations, provider support, or medical claims

✅ Strong understanding of claims adjudication, eligibility, and prior authorization processes

✅ Experience in provider-facing or B2B healthcare support strongly preferred

✅ Strong written and verbal communication skills with the ability to explain complex information clearly

✅ Excellent problem-solving skills and ability to navigate ambiguous situations

✅ Strong attention to detail and documentation accuracy

✅ Ability to manage multiple priorities in a fast-paced, high-volume environment

✅ Experience working independently in a remote or hybrid setting

✅ Familiarity with HIPAA and patient confidentiality requirements

Preferred Experience

• Availity, Zelis, or similar clearinghouse platforms
• Contact center or case management systems
• CRM or healthcare support systems
• Understanding of common claim denial reasons and healthcare payment cycles
• Bachelor's degree in Healthcare Administration or a related field, or equivalent experience

Tools & Systems

You'll work with or have the opportunity to learn:

• Provider portals and clearinghouses, such as Availity and Zelis
• CRM and case management systems
• Internal knowledge bases and documentation tools

If you're looking to use your healthcare claims, provider support, or healthcare operations experience in a role where you can solve complex problems, build provider relationships, and contribute to process improvements, we'd love to hear from you!

📩 Apply today or message us to learn more!

About Us

Russell Tobin is a leading staffing and recruiting agency connecting talented professionals with top companies across finance, technology, operations, customer service, and more. We partner with clients and candidates throughout the hiring process to create the right match and support career growth.

Russell Tobin is part of the Pride Global family of companies, providing access to a broad talent network and workforce solutions.

What We Offer

Pride Global offers eligible employees a comprehensive benefits package, including:

• Medical, dental, and vision coverage
• Supplemental insurance (accident, critical illness, and hospital indemnity)
• 401(k) retirement savings plan
• Life and disability insurance
• Employee Assistance Program (EAP)
• Legal support services
• Auto, home, and pet insurance options
• Employee discounts with preferred vendors

More about us:

Equal Employment Opportunity

Russell Tobin is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment

Russell Tobin is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations

We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

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