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provider relations specialist

512 provider relations specialist jobs found

AF Group
08/19/2026  
Provider Relations Specialist
SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...
AF Group Lansing, MI Full Time
AF Group
08/12/2026  
Provider Relations Specialist
SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...
AF Group Lansing, MI Full Time
AF Group
06/17/2026  
Provider Relations Specialist
SUMMARY:  Provider Relations Specialist I Responsible for servicing internal and external customers who contact AF Group via the ACD phone line. Responsible for providing quality, consistent and accurate medical payment information to internal and external customers.  Provider Relations Specialist II Responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.  PRIMARY RESPONSIBILITIES:  PRIMARY RESPONSIBILITIES: Provider Relations Specialist I •    Utilizes ACD phone lines to manage incoming calls and inquiries. •    Provides high level of customer service for all internal or external customers thru telephonic, email and fax. •    Demonstrates dependable work ethic. •    Manages confidential client information with discretion and good...
AF Group Lansing, MI Full Time
Pinnacol Assurance
08/17/2026  
Bilingual Claims Representative
Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers’ compensation protection to Colorado employers and employees. Although employers are required by law to provide Worker’s Comp insurance, we believe our service is making a meaningful impact in worker’s lives across Colorado in their moments of need. We have big hearts and love big ideas. We’ve been around for over 100 years, but don’t let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative of ways! We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence. What you’ll do: Work with team members to strategically and proactively manage claims and claim-related issues to the most expedient, cost effective resolution; provide quality customer service to all stakeholders. Identify claims that need additional management and work with team members to resolve concerns or escalate to the...
Pinnacol Assurance Denver, CO
CorVel
07/28/2026  
Provider Relations Sp I
The Provider Relations Specialist assists providers via phone and email with bill review questions and requests of varying complexity. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling consistent, timely delivery of our quality services. This role may be transitioned into a Knowledge Center Representative role within the first year of employment, based on business needs. While both the Provider Relations Specialist and the Knowledge Center Representative roles are customer support roles with overlapping core functions, specific responsibilities pertaining to only the Knowledge Center Rep role are marked as such in the below job description. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate clearly and...
CorVel Folsom, CA Full Time
Reliance Matrix
07/28/2026  
ADA Specialist
Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Workforce Accommodations Specialist will work closely with the employee, healthcare provider and employer to explore accommodations that will assist the employee in performing the essential functions of their job. The Specialist reviews complex medical information for temporary and permanent accommodation requests; and works with the client to identify reasonable accommodations under the ADAAA, state law, PWFA and/or client requirements.   Duties and Responsibilities: Conduct thorough and confidential assessments of accommodation requests, including reviewing medical documentation and engaging in an interactive process with employees and their supervisors/HR Partners. Serve as the primary point of contact for employees with disabilities, providing guidance and support in requesting and implementing reasonable accommodations. Manage a caseload of open accommodation requests....
Reliance Matrix United States Full Time
Higginbotham
05/29/2026  
ERC Benefit Specialist
Position Summary:   The Employee Response Center (ERC) Benefits and Claims Specialist is a key role in the Financial Services Day 2-ERC Department at Higginbotham. The roles is responsible for ensuring a thorough knowledge of claims, research tools, and resources to serve employees and employers effectively. This role is centered around evaluating and reviewing claims with precision and accuracy. The individual must be meticulous to determine the claims’ validity and ensure that insurance carriers’ payments are made per policy terms and regulatory requirements. The ERC Benefits and Claims Specialist will also support as backup to the ERC Benefits Specialists, take employee calls, and respond to emails and texts as needed during non-peak and peak times. Supervisory Responsibilities:   None Essential Tasks: Maintaining documentation, spreadsheets, products, and services as requirements change Serving as a subject matter expert on reviewing and assessing insurance...
Higginbotham Fort Worth, TX Full Time
Great American Insurance Group
08/21/2026  
Senior Safety and Loss Control Specialist
Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. This is a field-based position located in the northwest Georgia area responsible for servicing workers' compensation policyholders throughout Georgia. Regular travel is required to conduct on-site risk...
Great American Insurance Group GA Full Time
Encova Insurance
08/21/2026  
Lost Time Claims Specialist - Workers' Compensation
The salary range for this job posting is $55,132.00 - $110,642.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. Candidates may live in any of our listed payroll approved states. This position will manage Workers' Compensation lost time and complex medical only claims. Claims handling experience in Iowa, Wisconsin and Kentucky are strongly preferred. The role reports to the Director, Workers' Compensation Claims. We may hire a senior level depending on the candidate's background and experience and this range is inclusive of all levels. Are you a Referral? If you know a current Encova Insurance associate and would like...
Encova Insurance United States Full Time
EPIC Insurance Brokers & Consultants
08/21/2026  
Vice President- P&C Claims
Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in New York City and founded in 2007, our company has over 4,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our...
EPIC Insurance Brokers & Consultants Rancho Cordova, CA
EPIC Insurance Brokers & Consultants
08/21/2026  
Vice President- P&C Claims
Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in New York City and founded in 2007, our company has over 4,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our...
EPIC Insurance Brokers & Consultants San Francisco, CA
EPIC Insurance Brokers & Consultants
08/21/2026  
Vice President-P&C Claims
Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in New York City and founded in 2007, our company has over 4,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.  Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our...
EPIC Insurance Brokers & Consultants Newport Beach, CA
Summit
08/21/2026  
Senior Safety and Loss Control Specialist
Summit provides independent insurance agents and their clients with market-leading workers’ comp insurance and elite customer service. We’re growing and currently serve more than 7,000 independent agents and 31,000 policyholders across the South, Midwest, and Mid-Atlantic.   Our strength comes from a single-minded focus on workers’ comp and a commitment to long-term customer relationships. Summit is who you turn to when you need a specialist who not only knows workers’ comp but also gets to know your business and your priorities.   Our field team members are located in every state in which we operate.   Summit is a member of the Great American Insurance Group where our highest goal is for all employees to feel included, respected, and empowered to perform at their best. This is a field-based position located in the northwest Georgia area responsible for servicing workers' compensation policyholders throughout Georgia. Regular travel is required to conduct on-site risk...
Summit GA Full Time
Berkshire Hathaway GUARD
08/21/2026  
Learning & Development Specialist
Overview Good Things Start Here. Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers. Good Things You Can Count On. Hybrid schedule: 2 days remote / 3 in‑office Predictable hours (no nights, weekends, or holidays) Competitive pay + generous PTO Medical, dental & vision starting day one 401(k), tuition reimbursement & longevity bonuses Responsibilities Berkshire Hathaway GUARD Insurance is looking to hire a detail-oriented and enthusiastic Learning & Development Training Specialist to join our team. In this critical role, you will oversee the onboarding process for all new hires, ensuring a seamless and positive experience as they...
Berkshire Hathaway GUARD Wilkes-Barre, PA Full Time
USAA
08/21/2026  
Property Claims Adjuster Specialist - Field
Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist , you will work within established guidelines and framework to investigate, evaluate, negotiate, and settle complex property insurance claims presented by or against our members. You will confirm and analyzes coverage, recognize liability exposure and negotiate equitable settlements...
USAA OH Full Time
USAA
08/21/2026  
Property Adjuster Specialist - Specialty Claims
Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory...
USAA San Antonio, TX Full Time
USAA
08/21/2026  
Property Adjuster Specialist - Field Claims
Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory...
USAA United States Full Time
USAA
08/21/2026  
Property Adjuster Specialist - Field
Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Property Adjuster Specialist, you will work within defined guidelines and framework, investigate, evaluate, negotiate, and settle complex property insurance claims. You will confirm/analyze coverage, recognize liability exposure and negotiate equitable settlement in compliance with all state regulatory...
USAA United States Full Time
UFG Insurance
08/21/2026  
Claims Specialist II - MCU
UFG is currently hiring for a Claims Specialist II whose primary responsible for investigating, evaluating, negotiating and settling moderate to high complexity claims within (CD, E&S).  This position requires extensive experience in claims handling.  This position is responsible for conducting timely and thorough investigations, verifies applicable coverages, analyzes liability, evaluates damages for reserve and settlement, and negotiates claims to resolution in accordance with claims best practices.   The Claims Specialist II position promotes a positive work environment encouraging their team members to be the best they can be and are willing to take on additional challenges as needed.  They buy into a strong service mentality for both internal and external customers.  This position requires a high EQ, strong soft skills and technical skills, strong communication skills, attention to detail, and the ability to handle multiple tasks efficiently and effectively....
UFG Insurance Full Time
GEICO
08/21/2026  
Product Specialist
Why Join GEICO? At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities.   Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive on relentless innovation to exceed our customers' expectations while making a real impact on local communities nationwide.   Founded in 1936, GEICO is a member of the Berkshire Hathaway family of companies and one of the largest auto insurers in the United States. When you join our company, we want you to feel valued, supported, and proud to work here. That's why we offer the GEICO Pledge: Great Company, Great Culture, Great Rewards, and Great Careers. GEICO is seeking a Product Specialist. In this role, you will play a crucial role in ensuring compliance, regulatory adherence, and efficient administration of insurance products across various states. You will focus on organizing...
GEICO Bethesda, MD Full Time

 

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