Provider Relations Specialist

Russell Tobin is seeking a Provider Relations Specialist to serve as the primary point of contact for provider communication and engagement. In this role, you will connect with healthcare providers to educate them about Ametros, CareGuard, and other professional administration services. You will build and maintain strong relationships with provider groups, ensure accurate billing processes, and support overall member success.

Job title: Provider Relations Specialist

Location: Wilmington MA

Duration: 6 months

Pay rate: $25-$27/hour

Description of duties:

Key Responsibilities

• Educate providers on professional administration services, CareGuard, and proper billing processes.
• Develop and maintain relationships with large provider groups and health systems nationwide through proactive outreach and regular meetings.
• Engage in high-level discussions with practice administrators, managers, and healthcare leadership.
• Participate in regional provider and physician conferences to promote CareGuard and related services.
• Collaborate cross-functionally with the Member Onboarding and Member Engagement teams on complex cases.
• Conduct proactive outreach to ensure member appointment attendance and correct provider billing.
• Deliver training, orientation, and coaching to enhance provider network performance and assist with claim resolution.
• Serve as the main point of contact for provider escalations and act as a liaison between providers and CareGuard.
• Investigate, resolve, and communicate provider claim issues and process updates effectively.

Qualifications

• 3 years of experience in provider office operations, billing, provider relations, or network management.
• 3 years of experience in healthcare or workers’ compensation.
• Solid understanding of medical or workers’ compensation billing and/or claims processing.
• Strong written and verbal communication skills with a professional presence.
• Proficiency in Microsoft Office (Outlook, Word, Excel, etc.).
• Excellent organizational and time management abilities.
• Knowledge of Medicare and/or Medicare Set-Aside Accounts (MSA) preferred.

“Russell Tobin offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.”