Job Description
We’re looking for a Provider Specialist to join our Claims team at MBPS. In this role, you are expected to review and process long‑term care claim initiation requests, ensuring accuracy, completeness, and timely progression using sound judgment and multiple systems. You will also handle policyholder follow‑ups, urgent vendor requests, and escalations, ensuring efficient resolution and strong coordination to support a seamless claims experience.
Position Responsibilities
- Reviews and processes requests from external customers to initiate long‑term care claims, ensuring forms are complete and in good order to avoid delays.
- Exercises sound judgment, supported by system tools, to determine claim readiness and eligibility for initiation.
- Contacts policyholders (via call or system‑generated letter) when submissions are incomplete, selecting the most appropriate follow‑up approach.
- Handles urgent vendor requests promptly to support ti...