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Managed Care Representative Jobs (NOW HIRING)

The Urgent Care

Patient Care Representative

La Place, LA · On-site

$15.50 - $19.25/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

The Urgent Care

Patient Care Representative

La Place, LA

$15.50 - $19.25/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

The Urgent Care

Patient Care Representative

La Place, LA · On-site

$10 - $15/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

The Urgent Care

Patient Care Representative

Harvey, LA · On-site

$15.50 - $19.25/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

The Urgent Care

Patient Care Representative

Gretna, LA · On-site

$14.75 - $18/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

The Urgent Care

Patient Care Representative

Gretna, LA · On-site

$14.75 - $18/hr

... managing the waiting room, answering phone calls, making check-in times, triage patients, and ... Great job opportunity for entry-level. Patient Care Representative Duties and Responsibilities:

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Managed Care Representative information

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$24.5K

$44.2K

$77K

How much do managed care representative jobs pay per year?

As of Sep 13, 2026, the average yearly pay for managed care representative in the United States is $44,219.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,500.00 and $43,000.00 per year, depending on experience, location, and employer.

What is a managed care representative?

Managed Care Representatives are professionals who serve as liaisons between healthcare providers, insurance companies, and patients to ensure efficient coordination of care and benefits. They help negotiate contracts, explain insurance coverage, and resolve billing or authorization issues. Their goal is to streamline communication and ensure that patients receive the care they need while managing costs for healthcare organizations.

How does a managed care representative typically collaborate with healthcare providers and insurance companies?

A Managed Care Representative serves as a vital link between healthcare providers, patients, and insurance companies. They regularly communicate with providers to clarify coverage details, facilitate authorizations, and resolve billing or reimbursement issues. This role often involves problem-solving and negotiating solutions to ensure that patients receive necessary care while maintaining compliance with payer policies. Effective collaboration and clear communication are key to building strong working relationships and ensuring smooth care coordination.

What are the key skills and qualifications needed to thrive as a managed care representative, and why are they important?

A Managed Care Representative typically needs a background in healthcare administration, customer service, and knowledge of insurance or managed care processes, often supported by a relevant degree or experience. Familiarity with claims processing systems, healthcare databases, and industry software such as Microsoft Office or CRM platforms is essential. Strong interpersonal skills, attention to detail, and problem-solving abilities help build effective relationships with providers, payers, and patients. These competencies ensure efficient handling of claims, clear communication, and improved satisfaction among stakeholders in managed care environments.

What is the difference between Managed Care Representative vs Insurance Claims Specialist?

AspectManaged Care RepresentativeInsurance Claims Specialist
CredentialsHigh school diploma or equivalent; some roles may require insurance or healthcare certificationsHigh school diploma; certifications like Certified Claims Professional (CCP) are common
Work EnvironmentHealthcare insurance companies, managed care organizations, customer service centersInsurance companies, healthcare providers, claims processing departments
Employer & IndustryHealthcare insurance industry, managed care organizationsInsurance industry, healthcare providers
Primary FocusCommunicating plan benefits, resolving member issues, explaining coverageReviewing, processing, and adjudicating insurance claims

While both roles involve healthcare insurance, Managed Care Representatives focus on member communication and plan details, whereas Insurance Claims Specialists handle the processing and adjudication of claims. Understanding these differences helps job seekers find the right position aligned with their skills and career goals.

What states have the most Managed Care Representative jobs?

States with the most job openings for Managed Care Representative jobs include:

What are popular job titles related to Managed Care Representative jobs?

For Managed Care Representative jobs, the most frequently searched job titles are:

Managed Care Representative jobs near you

Patient Care Representative

Mountain View, CA • On-site

Silicon Valley Medical Development
Health Care and Social Assistance • 201 - 500 employees
Learn more about Silicon Valley Medical Developmentexternal

$31/hr

Other

This job post has expired today. Applications are no longer accepted.

Job description

Patient Care Representative

El Camino Health Medical Network is currently seeking a talented Patient Care Representative to join our growing healthcare team!

Location: Mountain View, CA

Schedule: Monday-Friday

Shift: 8:00am-5:00pm

Pay: $31.00/ hour

El Camino Health Medical Network is recruiting Patient Care Representatives for our El Camino Health Primary Care and Multi-Specialty Care outpatient practices located in Santa Clara County. The Patient Care Representative (PCR) is the primary point of contact for the practice's patients. He/she contributes to the overall patient experience and satisfaction. Responsibilities include: answer telephone calls and relay messages, schedule appointments, verify patients' demographics and insurance information. Additionally, the PCR will review patients' medical records to assist with patient inquiries, requests for medication refills and coordinate Release of Record requests.

Patient Registration

  • Registers patients and updates existing patient accounts in a courteous and professional manner
  • Determines if patient has a co-payment or deposit; accepts and records receipt of payment; provides applicable waiver and obtains appropriate signatures; and, when appropriate, scans copy of patient's photo ID, insurance card and/or waiver
  • Handles any system red flags as they are encountered
  • Assist patients with registering for MyCare health record system

Call Management

The following activities are performed when assigned to Call Management

  • Handles incoming calls, makes appointments, sends task to providers and support staff as needed
  • Assures all urgent calls are handled in a timely manner

Communication and Front-Office Procedures

The following activities are expected to be performed in a timely, courteous and professional manner in accordance with service level standards:

  • Greet patients and others entering the department
  • Schedules new or follow-up appointments
  • Responds to requests from patients, family members, physicians and staff

Electronic Medical Record (EMR) Documentation

  • Manages EMR in-basket(s), work queues and schedule templates as assigned

Cashiering

  • Reconciles cash sheet and cash drawer, completes daily and monthly deposit summaries

All other duties as assigned including department-specific functions and responsibilities

  • Contributes to the overall patient experience and satisfaction
  • Participates in performance improvement activities
  • Performs other duties as assigned
  • Adheres to HR, safety, HIPAA and compliance policies, and attendance requirements

Performs work in accordance with established schedules, policies and procedures

Requirements

  • High School Diploma or GED
  • Minimum 2 years of experience as a Patient Care Representative or in a customer service/guest relations role preferred
  • Experience working with an EMR
  • Ability to accurately type a minimum of 40 WPM
  • Strong verbal and written communications, and active listening skills
  • Solid patient/guest relations skills with the ability to communicate in a professional, courteous and efficient manner
  • Excellent interpersonal and telephone communications skills
  • Legible handwriting
  • Basic math skills necessary to collect payments and balance cash drawer
  • Excellent attention to detail
  • Basic computer skills to include keyboarding, mouse movement and data entry skills to enter information accurately into the EPIC EMR
  • Ability to maintain composure during challenging interpersonal interactions
  • Ability to effectively organize and prioritize tasks in order to complete assignments within the time allotted to maintain standard workflow
  • Ability to work effectively as a team member who is flexible, cooperative and willing to assist others
  • Associates degree preferred
  • EPIC EMR experience preferred
  • Bilingual skills preferred

Apply