Provider Service Representative I
WeShare Health, Orange, CA, United States
About This Role
The Provider Service Representative I at UHSM is an experienced member of the Provider Services team. This representative is responsible for handling more complex provider inquiries, resolving escalated billing issues, and supporting process improvements across the provider network. This role requires strong analytical skills, deeper knowledge of healthcare customer service workflows, and the ability to work cross‑functionally to ensure providers receive accurate, timely, and high‑quality support.
Key Responsibilities Provider Relationship Management
Manage high volume of inbound/outbound calls, escalated provider inquiries, emails, and chats to assist healthcare professionals with inquiries and requests, ensuring timely and accurate resolution.
Serve as a resource for complex questions related to WeShare policies, benefits, and provider requirements.
Support provider onboarding, contracting, credentialing, and network management activities in collaboration with internal teams.
Build strong relationships with high‑volume or high‑priority providers to ensure a positive experience and smooth operational workflow.
Identify recurring provider call issues or trends and recommend process improvements to reduce errors and improve provider satisfaction.
Data Entry and Documentation
Maintain detailed, accurate documentation of provider interactions, case resolutions, and case notes.
Perform quality checks on provider data to ensure accuracy and consistency.
Customer Service and Support
Provide high‑level support to providers regarding benefits, coverage, claim status, and billing inquiries.
Handle sensitive or urgent cases requiring advanced problem‑solving and cross‑department coordination.
Required Qualifications
High school diploma or equivalent.
At least 1 year of experience in a customer service or provider service call center role, preferably in healthcare.
Proven ability to manage high call volumes while handling complex or escalated cases.
Strong understanding of medical billing and healthcare terminology.
Preferred Qualifications
Bachelor's degree.
Strong communication and interpersonal skills, with the ability to effectively interact with healthcare providers and internal teams.
Detail‑oriented and highly organized, with a focus on accuracy and efficiency in data entry and documentation.
Customer service mindset, with a commitment to delivering excellent service to providers.
Ability to multitask and prioritize tasks in a fast‑paced environment.
Proficiency in Microsoft Office Suite and experience with database systems (experience with healthcare‑specific software a plus).
What We Offer
Competitive hourly pay.
Health, Dental, Vision, and 403(b) benefits.
Opportunity to make important enhancements to the healthcare industry.
Great culture where you work with founders and key stakeholders in a relaxed, but innovative atmosphere.
UHSM is an Equal Opportunity Employer. Our business is fast‑paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.
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Key Responsibilities Provider Relationship Management
Manage high volume of inbound/outbound calls, escalated provider inquiries, emails, and chats to assist healthcare professionals with inquiries and requests, ensuring timely and accurate resolution.
Serve as a resource for complex questions related to WeShare policies, benefits, and provider requirements.
Support provider onboarding, contracting, credentialing, and network management activities in collaboration with internal teams.
Build strong relationships with high‑volume or high‑priority providers to ensure a positive experience and smooth operational workflow.
Identify recurring provider call issues or trends and recommend process improvements to reduce errors and improve provider satisfaction.
Data Entry and Documentation
Maintain detailed, accurate documentation of provider interactions, case resolutions, and case notes.
Perform quality checks on provider data to ensure accuracy and consistency.
Customer Service and Support
Provide high‑level support to providers regarding benefits, coverage, claim status, and billing inquiries.
Handle sensitive or urgent cases requiring advanced problem‑solving and cross‑department coordination.
Required Qualifications
High school diploma or equivalent.
At least 1 year of experience in a customer service or provider service call center role, preferably in healthcare.
Proven ability to manage high call volumes while handling complex or escalated cases.
Strong understanding of medical billing and healthcare terminology.
Preferred Qualifications
Bachelor's degree.
Strong communication and interpersonal skills, with the ability to effectively interact with healthcare providers and internal teams.
Detail‑oriented and highly organized, with a focus on accuracy and efficiency in data entry and documentation.
Customer service mindset, with a commitment to delivering excellent service to providers.
Ability to multitask and prioritize tasks in a fast‑paced environment.
Proficiency in Microsoft Office Suite and experience with database systems (experience with healthcare‑specific software a plus).
What We Offer
Competitive hourly pay.
Health, Dental, Vision, and 403(b) benefits.
Opportunity to make important enhancements to the healthcare industry.
Great culture where you work with founders and key stakeholders in a relaxed, but innovative atmosphere.
UHSM is an Equal Opportunity Employer. Our business is fast‑paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.
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