Provider Inquiry Specialist - US Healthcare BPM

Role Overview UST is looking for a detail-oriented Provider Inquiry Specialist to join its Business Process Management team at the Chennai or Trivandrum or Kochi delivery centres. This is a night shift, work-from-office role supporting US Healthcare operations, where you will be responsible for reviewing and resolving provider inquiries related to claims, eligibility, benefits, authorizations, and payment details. The ideal candidate brings 3 to 5 years of hands-on experience in US Healthcare back-office operations and a strong commitment to quality, compliance, and turnaround standards. Key Responsibilities - Review and investigate provider inquiries submitted through ticketing or portal-based systems such as PEAR and OneHub - Analyse inquiries covering claim status, payment details, eligibility and benefits, authorization status, and claim denials or adjustments - Provide clear, accurate, and provider-friendly written responses with appropriate explanations and resolution details - Research claim information using payer systems and supporting tools to identify the correct resolution path - Route inquiries requiring corrections, adjustments, or further investigation to the appropriate internal queues or teams - Document all actions, research findings, and responses accurately within the case management or tracking system - Ensure strict adherence to SLA, TAT, and quality benchmarks established for the Provider Inquiry process - Prioritise workload effectively to support backlog and aging clearance based on turnaround requirements - Participate in quality feedback sessions, calibration meetings, and cross-audits to reduce repeat errors - Adhere to HIPAA guidelines and all organisational compliance standards at all times Required Qualifications - Graduate in any discipline - 3 to 5 years of experience in US Healthcare operations, specifically in Provider Inquiry, Provider Support, Claims, or Call Centre back-office functions - Strong understanding of US Healthcare claims workflows, provider support processes, and payer-side systems - Proficiency or working knowledge of tools such as PEAR Portal, PPM, OneHub, Pulse, Aerial, CFI, Burgess, or HealthRule - Familiarity with US healthcare terminology including EOB, CPT, ICD codes, authorizations, deductibles, and copay - Excellent written communication skills with the ability to frame clear and business-friendly provider responses - Ability to manage high volumes of repetitive tasks with accuracy, attention to detail, and documentation discipline - Comfortable working in a fast-paced environment with shifting priorities and tight deadlines Why Join Us UST is a globally recognised technology and services company that values Humility, Humanity, Integrity, and Excellence in everything it does. Joining the UST BPM team means being part of a culture that prioritises empathy, ethical practice, and continuous improvement while delivering high-quality outcomes for leading US Healthcare clients.

- 3 to 5 years of experience in US Healthcare operations - Graduate in any discipline - Experience in Provider Inquiry, Provider Support, Claims, or Call Centre back office - Strong analytical and problem-solving skills - Excellent written communication skills - Knowledge of HIPAA compliance standards - Familiarity with PEAR Portal, OneHub, or similar ticketing systems - Understanding of US healthcare terminology such as EOB, CPT, ICD, and authorization - Ability to handle high-volume tasks with accuracy and attention to detail - Willingness to work US night shift (5:30 PM to 2:30 AM IST)

- Work with a globally recognised IT and BPM organisation - Exposure to US Healthcare domain and leading payer-side tools - Structured quality feedback and professional development sessions - Collaborative and compliance-driven work culture - Five-day work week