Private Health Management (PHM) guides patients and families through the complexity of serious medical care, including cancer and other high-acuity conditions. The company is hiring two Shared Services Specialists to support a flexible, cross-functional operating model across Provider Network, Partner Benefits, and Medical Records.
This role is designed to build expertise across multiple shared services functions rather than a single narrow specialty. One hire will begin in Provider Network and Partner Benefits, while the other will begin in Provider Network and Medical Records. Over time, both team members will cross-train into all three areas to provide coverage, respond to changing volumes, and help Care Teams and clients get answers faster.
What you'll do
- Build working knowledge across Provider Network, Partner Benefits, and Medical Records
- Deliver accurate, high-quality operational support across multiple service lines
- Improve turnaround times for Care Teams by handling requests efficiently and reliably
- Become a trusted resource who researches thoroughly, completes work accurately, and works with increasing independence
- Support workflow improvements through technology, AI, and process enhancements
- Contribute to a collaborative, continuously improving shared services team
Provider Network focus
- Research providers, verify credentials, and vet providers to keep the provider database accurate
- Conduct provider outreach and maintain provider records and documentation
- Support provider data quality and operational requests from Care Teams
Partner Benefits focus
- Research and interpret commercial, employer-sponsored, and Medicare health benefits
- Verify insurance coverage and explain benefit information to support Care Teams
- Document findings clearly and consistently while following established SOPs
Medical Records focus
- Request medical records from provider offices, hospitals, and facilities
- Follow up on outstanding requests and document collection status accurately
- Coordinate with Care Teams and Medical Records colleagues to help avoid delays
- Bachelor's degree strongly preferred
- Strong knowledge of commercial health insurance, employer-sponsored plans, Medicare, and common healthcare benefit concepts
- Ability to interpret plan documents and navigate complex scenarios
- Exceptional research and critical thinking skills
- Ability to synthesize information from multiple sources
- Strong attention to detail and commitment to accurate work
- Adaptability and willingness to cross-train across multiple healthcare functions
- Comfort using technology, AI tools, and multiple systems to improve efficiency and quality
- Experience in a health plan, provider office, hospital, healthcare navigation, care management, or similar healthcare environment is preferred
- Familiarity with provider research, credential verification, provider directories, healthcare databases, or medical records collection is a plus
- Experience supporting authorizations, referrals, claims, or appeals is a plus
- Target hourly rate: $26.44 to $31.25 per hour
- Health, dental, and vision benefits
- 401(k) with match
- Paid time off
- PHM for PHM services for employees and dependents
- Other benefits as part of the total compensation package
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago