Provider Relations Officer

About the role

The Provider Relations Officer is responsible for managing the end‑to‑end claims process and maintaining strong relationships with service providers to ensure a seamless client experience.

Key responsibilities

• Assess, evaluate and process claims requests in line with policy contracts and internal procedures.
• Engage with service providers to enhance client satisfaction and resolve service complaints.
• Assist in assessments, accreditation, price‑tariff negotiations, claim reconciliations and approval of service agreements.
• Detect, decline and report fraudulent or fictitious claims.
• Ensure compliance with internal policies, regulatory requirements and risk‑management standards.
• Log initial claims, resolve discrepancies, and coordinate validation and approval with supervisors.
• Collaborate with Finance to process claim payments within agreed timelines.
• Generate reports, perform data reconciliation and maintain system integrity.
• Train provider staff on claims software and conduct regular site visits to address concerns.

Required profile

• Strong attention to detail and ability to detect irregularities in claims.
• Experience in vendor or provider relationship management.
• Knowledge of claim processing, accreditation and tariff negotiation.
• Understanding of risk‑management and regulatory compliance.
• Ability to work closely with finance, client relations and supervisory teams.

Required skills

What we offer

• Opportunity to work in a dynamic environment focused on client satisfaction.
• Exposure to comprehensive claims and provider management processes.