Support Specialist

About the Job

Russell Tobin is seeking a proactive and detail-oriented Support Specialist to support the Provider Services team. This role is ideal for a professional with healthcare operations, provider support, or medical claims experience who can confidently handle complex inquiries and provide accurate, timely support to healthcare providers and their staff.

📍 Location: Lehi, UT

📅 Contract: Contract

💲 Pay: $22.00 --- $24.00

Key Responsibilities

• Serve as a primary point of contact for healthcare providers via phone and provider portal messaging
• Build and maintain strong relationships with provider offices
• Investigate and resolve complex inquiries related to claims, benefits, billing, and administrative processes
• Support questions regarding claims submission, status, and adjudication
• Explain benefit and plan information, member cost-sharing, and billing questions
• Assist with prior authorizations, coordination of benefits, appeals, and overpayment recoupment
• Verify and communicate patient eligibility, coverage details, and accumulator balances
• Document all provider interactions accurately within internal systems
• Collaborate with Claims, Product, Network, and other internal teams to resolve issues
• Identify trends and escalate systemic issues for root cause analysis
• Contribute to improvements in internal tools, workflows, and training materials
• Educate providers on self-service tools and best practices
• Meet established Service Level Agreements (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
• Excellent written and verbal communication skills
• 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
• Strong problem-solving skills and ability to navigate ambiguity
• Experience in provider-facing or B2B healthcare support preferred
• Familiarity with Availity, Zelis, or similar clearinghouse platforms preferred
• Experience with contact center and case management systems preferred
• Understanding of common claim denial reasons and healthcare payment cycles preferred
• Bachelor's degree in Healthcare Administration or related field, or equivalent experience, preferred

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

If you are a customer-focused and tech-savvy professional who enjoys troubleshooting and supporting end users in a dynamic environment, we encourage you to apply.

More About Us

Equal Employment Opportunity

Russell Tobin is an equal opportunity employer. We do not discriminate on the basis of 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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