MBPS
ProviderSpecialist
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“Provider Specialist at MBPS. Skills: claim initiation, policyholder follow-ups, vendor requests, escalations. Review and process claim initiation requests. Handle policyholder follow-ups”
What You'll Achieve.
ensuring accuracy, completeness, and timely progression; ensuring efficient resolution and coordination; support a seamless claims experience
Industry & Context.
problem-solving abilities
What They're Looking For.
Must Have
3 years of administrative or business operations experience, administrative background with a high level of accuracy and attention to detail, Excellent verbal communication skills with the ability to engage professionally with stakeholders, Proficient in Microsoft Office and overall computer skills, Excellent typing skills with the ability to produce quality work efficiently
Nice to Have
Highly organized, proactive, and demonstrates initiative and problem-solving abilities, Customer-focused, with experience in a service-oriented environmen, Ability to multitask, prioritize, and perform effectively in a fast-paced, deadline-driven environment, Collaborative mindset with the ability to work effectively within a team environment
What You'll Do.
Review and process claim initiation requests
Handle policyholder follow-ups
Handle urgent vendor requests
Manage escalations related to claim initiation
Utilize multiple claims systems effectively
How You'll Work.
Team & Collaboration
work effectively within a team environment
Communication Scope
Excellent verbal communication skills
Full Job Description
_We’re looking for a**Provider Specialist** to join our Claims team at MBPS. In this role, you are expected to review and process long-term care claim initiation requests, ensuring accuracy, completeness, and timely progression using sound judgment and multiple systems. You will also handle policyholder follow-ups, urgent vendor requests, and escalations, ensuring efficient resolution and strong coordination to support a seamless claims experience._ **Position Responsibilities:** * Reviews and processes requests from external customers to initiate long-term care claims, ensuring forms are complete and in good order to avoid delays. * Exercises sound judgment, supported by system tools, to determine claim readiness and eligibility for initiation. * Contacts policyholders (via call or system-generated letter) when submissions are incomplete, selecting the most appropriate follow-up approach. * Handles urgent vendor requests promptly to support timely claim progression. * Manages escalations related to claim initiation, requirements, or follow-ups, ensuring thorough and accurate resolution. * Utilizes multiple claims systems effectively, maintaining a strong working knowledge of each. * Performs additional tasks and responsibilities as assigned. **Required Qualifications:** * At least 3 years of administrative or business operations experience * Strong administrative background with a high level of accuracy and attention to detail * Excellent verbal communication skills with the ability to engage professionally with stakeholders * Proficient in Microsoft Office and overall strong computer skills * Excellent typing skills with the ability to produce quality work efficiently **Preferred Qualifications:** * Highly organized, proactive, and demonstrates strong initiative and problem-solving abilities * Customer-focused, with experience in a service-oriented environmen. * Ability to multitask, prioritize, and perform effectively in a fast-paced, deadline-driven environment
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