Position Overview

Self Fund Health is seeking a detail-oriented and analytical Provider Payment Specialist to support the operational and financial processes that help make our provider payment model successful. This role is responsible for obtaining good faith estimates, analyzing healthcare costs across in-network and cash-based providers, generating member cash cards, educating members on documentation and receipt submission requirements, and ensuring provider invoices are accurate and complete.

This role works closely with nurse navigators by providing cost analysis, payment support, and pricing information that helps inform member recommendations. This position does not perform care navigation directly, but serves as an important operational partner to the care navigation team.

This is an ideal opportunity for someone who is highly organized, comfortable working across provider billing and payment workflows, and passionate about helping improve the affordability and accessibility of healthcare.

Key Responsibilities

• Work with provider billing teams to obtain good faith estimates for scheduled services.

• Complete healthcare cost analyses for in-network and cash-based providers to support cost-effective provider selection.

• Generate cash cards for members receiving approved services.

• Educate members on how to use cash cards, what documentation is required, and how to upload receipts.

• Partner with nurse navigators by providing timely cost information and operational support related to provider pricing and payment options.

• Support internal teams in identifying the most cost-effective provider and payment options for members.

• Review provider invoices for accuracy, completeness, and alignment with agreed pricing or estimates.

• Investigate and resolve invoice discrepancies with provider offices and internal stakeholders.

• Maintain accurate documentation related to estimates, invoices, receipts, and payments.

• Contribute to process improvements that increase accuracy, efficiency, and scalability across provider payment operations.

Qualifications

Required

• 2+ years of experience in healthcare operations, provider billing, revenue cycle, claims, payment administration, or a related field.

• Strong analytical skills with the ability to compare provider costs and evaluate pricing options.

• High attention to detail and accuracy in reviewing invoices, estimates, and documentation.

• Strong written and verbal communication skills.

• Ability to explain payment processes and documentation requirements clearly to members and provider offices.

• Strong organizational skills and the ability to manage multiple workflows at once.

• Proficiency in Excel or Google Sheets.

Preferred

• Experience working with provider billing teams, healthcare payment workflows, or reimbursement operations.

• Familiarity with good faith estimates, cash-pay arrangements, and receipt/documentation requirements.

• Experience working cross-functionally with care navigation, provider engagement, or healthcare cost containment teams.

• Experience in a fast-paced, growth-stage healthcare environment