Customer Service Representative- Provider Services
Do you enjoy solving problems and helping others succeed? As a Provider Service Representative, you’ll be the go-to resource for providers, vendors, and facilities—making sure they have the answers and support they need. You’ll guide them through eligibility, benefits, claims, and more, ensuring every interaction is clear, accurate, and professional.
This isn’t just a job—it’s an opportunity to make a real impact by building trust and confidence in our Health Plan. You’ll play a key role in strengthening provider relationships while delivering exceptional service.
Why You’ll Love This Role
- Competitive pay: $21.70/hour
- Comprehensive benefits: Health, dental, vision, and more
- Career growth: A clear path for advancement
- Training that sets you up for success: We provide full on-the-job training
- Flexibility: Work from home or choose an in-office option
- Standard hours: Monday–Friday, 8:00 a.m.–5:00 p.m.
(Candidates must live within 90 miles of Pittsburgh or Erie.)
What You’ll Do
- Be the primary point of contact for providers and vendors—answering questions about claims, benefits, authorizations, billing, and network participation.
- Respond to inbound calls, emails, and chats with professionalism and accuracy.
- Explain processes and policies clearly so providers know exactly what to do next.
- Research claims and benefits to provide timely, informed solutions.
- Document every interaction accurately in our systems.
- Navigate multiple tools while staying focused and responsive.
- Make outbound calls to provide updates or resolve issues.
- Stay current on policies and system updates through ongoing training.
- Collaborate with your team and participate in skill-building sessions.
What It Takes
This role is fast-paced and requires strong multitasking skills, quick thinking, and the ability to stay calm under pressure. If you’re organized, tech-savvy, and passionate about helping others, you’ll thrive here.
Work-From-Home Requirements
- Internet speed: 20 Mbps download / 5 Mbps upload
- Ping: , Jitter:
- Direct connection via Ethernet cable (WiFi and hotspots not allowed)
- Compatible service: Cable or fiber (Satellite, DSL, and mobile hotspots are not allowed) A speed test will be required upon offer acceptance.
Ready to make a difference and grow your career? Apply today and join a team that values your skills and commitment to service excellence!
- High school graduate or equivalent.
- 2 years customer service experience or call center experience required OR1 year health insurance call center and claims adjustments experience required.
- Proficient in typing and writing skills required.
- Ability to make independent decisions required.
- Knowledge of Microsoft Office and Excel spreadsheet program preferred.
- Complex analytical skills necessary to evaluate customer inquiries.
- Demonstrates good organizational skills.
- A desire to help others and portray empathy in all situations.
- Ability to learn complex health plan information.
- Demonstrate flexibility and motivation to learn & grow in the position.
- Flexibility in work schedule Licensure, Certifications, and Clearances: UPMC is an Equal Opportunity Employer/Disability/Veteran