Job Description

Role Overview:

As a Provider Communications Specialist at Infocrossing INC within our BPS-IHS division, you will be integral to our commitment to excellence in healthcare communication. Your main function is to ensure seamless, supportive, and efficient communication between MO Health Net healthcare providers and our organization. You will serve as a key point of contact, managing inquiries through multiple communication platforms, including phone calls, emails, and postal correspondence.

In this role, you will interpret and articulate complex healthcare claims data, policies, and coding guidelines, particularly ICD-10, guaranteeing providers receive clear, accurate, and comprehensive information. Mastery of healthcare claims systems such as MMIS, eMOMED, along with detailed Provider Manuals, will enable you to research provider questions thoroughly and provide timely, policy-compliant responses.

Your ability to balance multitasking under deadlines while maintaining exceptional quality standards will be vital in driving provider satisfaction and operational efficiency. Working in close coordination with cross-departmental teams, you will contribute insights and recommendations to optimize communication workflows and facilitate claims resolution processes.

This position offers a dynamic opportunity for professionals passionate about healthcare operations and provider relations who thrive in fast-paced environments and are motivated to make a significant impact on claims management and provider engagement.

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Key Competencies and Skills:

• Provider-Focused Engagement: Consistently prioritize provider needs by building trustful, empathetic relationships that foster collaboration and mutual understanding.

• Results-Oriented Mindset: Exhibit dedication to achieving and surpassing departmental objectives, enhancing overall provider experience and service quality.

• Detail-Oriented Execution: Demonstrate precision and rigor in managing communications and claims information to uphold high standards of accuracy and productivity.

• Team Collaboration: Proactively contribute to team efforts, sharing knowledge and fostering a supportive workplace culture that promotes continuous improvement.

• Adaptability and Learning Agility: Quickly integrate emerging knowledge about healthcare regulations, coding updates, and claims processing technologies into daily workflows.

• Analytical Problem Solving: Employ critical thinking to evaluate complex provider inquiries, ensuring solutions align with regulatory policies and enhance communication clarity.

• Clear and Professional Communication: Articulate information effectively and respectfully through spoken and written communication to diverse provider audiences and stakeholders.

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Preferred Experience and Qualifications:

The successful candidate will have a minimum of two years' experience delivering telephone-based customer service, ideally within healthcare or insurance sectors. Experience managing provider or patient relations, medical billing, or claims processing enhances your candidacy significantly.

• Proficiency with healthcare provider relations, demonstrating the ability to navigate complex provider networks and communication challenges.

• Experience in patient relations or customer service within healthcare settings, showing sensitivity to patient confidentiality and provider support needs.

• Strong background in insurance claims processing, familiar with procedural workflows and dispute resolution strategies.

• Hands-on knowledge of medical billing systems and practices, with an emphasis on accuracy and regulatory compliance.

• In-depth understanding of medical diagnostic and procedural coding principles, especially ICD-10 classification.

Candidates must excel at managing high-volume, fast-paced work environments, balancing multiple priorities while strictly adhering to departmental guidelines, deadlines, and quality benchmarks. Demonstrated ability to maintain composure and professionalism under pressure is essential.

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About Infocrossing INC and Our BPS-IHS Division:

Infocrossing INC, operating under the Business Process Services within the BPS-IHS EH GRP, is a forward-thinking organization dedicated to providing innovative healthcare communication and operational solutions. Our mission focuses on enhancing the provider experience and improving healthcare outcomes through dedicated support and advanced technologies.

We cultivate a diverse and inclusive workplace culture that inspires continuous learning, encourages creativity, and values every employee’s contribution. Our teams collaborate seamlessly across functions, empowering individuals to develop professionally while driving meaningful change in healthcare provider communications.

By joining Infocrossing INC, you become part of a dynamic environment that supports and challenges you to grow your skills and leadership capacities, while guiding the evolution of healthcare operational excellence.

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Why Choose to Join Our Team?

At Infocrossing INC and as part of Wipro, our parent company, you will be joining a global leader dedicated to digital transformation with an emphasis on continuous reinvention. Here, your professional aspirations are supported by a culture that encourages bold thinking, innovation, and personal growth.

We prioritize creating a workplace that welcomes all backgrounds and abilities, recognizing that diversity fuels our strength and innovation. Applications from individuals with disabilities and diverse experiences are highly encouraged.

Working with us means engaging in meaningful work that directly impacts the healthcare providers and patients we serve, contributing to a better healthcare ecosystem. You will have access to resources for ongoing skill development, collaborative team environments, and a culture that values your voice.

Our competitive compensation, including an expected hourly wage of $18.50, reflects our commitment to attracting and retaining talented professionals dedicated to excellence.