Provider Operations Specialist

Job Description

Job Description

Job Title : Provider Operations Specialist

Job Description

We are seeking a dedicated Provider Operations Specialist to join our dynamic team. The role involves managing daily interactions with providers and overseeing service request hubs, including emergency claims. You will play a crucial role in ensuring smooth provider operations by arranging claims, processing inquiries, and providing exceptional service follow-up.

Responsibilities

• Arrange with appropriate network and non-network providers to complete claims that cannot be automatically dispatched.
• Process provider inquiries and assist with special handling claims.
• Manage inbound and outbound calls and provider paperwork.
• Maintain provider profiles and liaise with other teams.
• Engage with potential new leads and provide support.
• Document and track activities in company systems.
• Follow policy and procedures for daily tasks.
• Find providers for claims when no in-network provider is available.
• Interpret contract language relating to enrollments, contracts, and agreements.
• Coordinate emergency / urgent work orders with customers and contractors.
• Negotiate with contractors for unusual or urgent work orders.
• Dispatch work orders following established guidelines.
• Proactively review and follow up on open claims.
• Respond promptly to customer and department emails regarding claims.
• Prepare and respond to data requests and execute work orders.

Essential Skills

Additional Skills & Qualifications

Work Environment

The work environment offers a hybrid model after one month of training, with work-from-home options on Mondays and Fridays. The office is located in Naperville, featuring modern amenities such as a gym, basketball court, coffee shop, and convenience store. The environment is energetic and collaborative, with a stylish kitchen area. Shifts are available from 9 AM to 5 : 30 PM or 10 AM to 6 : 30 PM. Peak seasons are unpredictable and depend on weather conditions.

Job Type & Location

This is a Contract to Hire position based out of Naperville, Illinois.

Pay and Benefits

The pay range for this position is $24.00 - $26.00 / hr.

Eligibility requirements apply to some benefits and may depend on your job

classification and length of employment. Benefits are subject to change and may be

subject to specific elections, plan, or program terms. If eligible, the benefits

available for this temporary role may include the following :

Workplace Type

This is a hybrid position in Naperville,IL.

Application Deadline

This position is anticipated to close on Oct 13, 2025.

About Aston Carter :

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.