Provider Relations Associate Analyst - EviCore - Remote

Provider Relations Associate Analyst

Summary:

The Provider Relations Associate Analyst acts as a key liaison between EviCore's contracted provider network and internal teams.

This role serves as the primary point of contact for provider and health plan inquiries, escalations, and operational issues.

Success in this role requires a strong understanding of claims processing, contracting, credentialing, prior authorization workflows, and client-specific requirements.

Key Responsibilities:

• Serve as the first line of support for contracted providers and health plans, addressing inquiries and resolving escalated issues.
• Facilitate communication between providers, health plans, and internal departments including operations, technology, and client services.
• Investigate and resolve operational issues related to claims, contracting, credentialing, eligibility, and complaints using defined processes and independent judgment.
• Ensure timely follow-up and resolution of provider concerns, maintaining clear documentation and communication throughout.
• Deliver high-quality service and ensure providers fully understand resolution outcomes and next steps.
• Navigate multiple internal platforms to access provider data, member information, authorizations, and claims.
• Support special projects through research, analysis, and ongoing maintenance to ensure operational efficiency and alignment with business and department goals.

Qualifications:

• Associate's degree or equivalent work experience required.
• Minimum of 2 years of experience in provider relations, client services, or healthcare operations.
• Strong working knowledge of claims processes is required.
• Proficiency in Microsoft Word and Excel (e.g., documentation, mail merges, data entry, spreadsheet creation).
• Experience with EMOS a plus
• Experience with ticketing or case management systems preferred.
• Must be able to work a full-time schedule (40 hours/week) within operating hours of 7:00 AM - 7:00 PM EST.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 20 - 30 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure.

That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.

Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.

We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

For more d...