Provider Customer Service Representative (Health Insurance)

Sutherland
San Antonio
Workplace: RemoteFull timeUSD 16+ hourlyFunction: Customer Support (Service Desk)Experience: 1-2 yearsEducation: high_schoolSkills: ["Communication","Active listening","Problem-solving","Multitasking","Customer support"]

Help healthcare providers with health insurance claim inquiries and workflows by handling status requests, denial rationales, appeals, and medical records. Verify provider participation, coverage, benefit grids, and credentialing, and support prior authorization/utilization management appeals. Manage phone calls with accurate documentation, drive resolutions, explain next steps, and educate providers on self-service tools like Availity while maintaining a strict schedule.

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FursaFursa
Sutherland
Sutherland
14 hours ago

Provider Customer Service Representative (Health Insurance)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI
Last checked: 12 hours agoStatus: Live

Job Summary

Help healthcare providers with health insurance claim inquiries and workflows by handling status requests, denial rationales, appeals, and medical records. Verify provider participation, coverage, benefit grids, and credentialing, and support prior authorization/utilization management appeals. Manage phone calls with accurate documentation, drive resolutions, explain next steps, and educate providers on self-service tools like Availity while maintaining a strict schedule.
Location: San Antonio
Workplace: Remote
Employment Type: Full time
Job Function: Customer Support (Service Desk)
Seniority: Entry level

Key Responsibilities

  • •Handle claims & authorization status inquiries, denial rationales, appeals, medical records, and EOB/EOP requests
  • •Verify eligibility by checking provider participation, coverage, medical benefit grids, and credentialing
  • •Manage call handling: document details, drive resolutions, and explain next steps
  • •Support authorizations/utilization management appeals and prior authorization verification
  • •Educate providers on self-service tools (e.g., Availity) and manage call documentation/back-to-back calls

Pay and Benefits

Salary: USD 16 hourly
Perks:Health InsuranceDentalVision

Key Requirements

  • •High School Diploma (or equivalent)
  • •1–2 years high-volume call center experience
  • •35–40 WPM typing and strong written/verbal communication
  • •Active listening, problem-solving, and multitasking skills
  • •Must be a US resident authorized to work in the US
Experience:1-2 yearsHealthcareHealth insuranceCall center
Education:High School
Skills:CommunicationActive listeningProblem-solvingMultitaskingCustomer support
Languages:English
Tech Stack:Availity

Eligibility

Work Authorization:Authorization required. Sponsorship not provided.

Company Brief

Sutherland
Global digital transformation and business process services firm offering AI, automation, cloud engineering, analytics and customer experience solutions to enterprises across industries.
Industry: Professional Services
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Funding: Private Equity Backed
Headquarters: Pittsford (Rochester), NY, United States
Founded: 1986
Glassdoor
Glassdoor: 3.5
WebsiteLinkedInGlassdoor