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...