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Provider Relations Representative Ii Jobs (NOW HIRING)

PrimeMSOSurgicalCenters

Provider Relations

Torrance, CA · On-site

$70K/yr

The Provider Relations Representative primarily handles communication and development for post ... Minimum of two years client-facing experience required * Strong organizational skills * Able to ...

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Provider Relations Representative Ii information

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How much do provider relations representative ii jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for provider relations representative ii in the United States is $27.89, according to ZipRecruiter salary data. Most workers in this role earn between $22.36 and $31.49 per hour, depending on experience, location, and employer.

What is a Provider Relations Representative II?

A Provider Relations Representative II is a healthcare professional who acts as a liaison between healthcare providers, such as doctors or clinics, and insurance companies or managed care organizations. They handle complex issues, ensure providers understand policies and procedures, and help resolve disputes or claims. This role typically involves a higher level of experience and responsibility than entry-level positions, including training new staff and handling escalated cases. Strong communication and problem-solving skills are essential for success in this position.

What are the key skills and qualifications needed to thrive as a Provider Relations Representative II, and why are they important?

To excel as a Provider Relations Representative II, you need strong knowledge of healthcare administration, provider contract management, and a bachelor’s degree in a related field. Familiarity with claims processing systems, CRM software, and healthcare regulations such as HIPAA is typically required. Outstanding interpersonal skills, problem-solving abilities, and effective communication are crucial for building trust with providers and resolving issues efficiently. These skills ensure smooth provider network operations, compliance, and high levels of provider satisfaction.

How does a Provider Relations Representative II typically collaborate with healthcare providers to resolve issues and ensure smooth operations?

A Provider Relations Representative II works closely with healthcare providers to address concerns related to claims processing, contract terms, and network participation. They act as a liaison between providers and the insurance company, facilitating communication and problem-solving. This often involves organizing meetings, conducting training sessions, and following up on outstanding issues to ensure providers have the support they need. Strong relationship-building and conflict resolution skills are essential, as representatives frequently collaborate with internal departments and external partners to maintain positive, productive partnerships.

What is the difference between Provider Relations Representative Ii vs Provider Relations Representative I?

AspectProvider Relations Representative IiProvider Relations Representative I
Required CredentialsHigh school diploma or equivalent; some roles may prefer healthcare or insurance certificationsHigh school diploma or equivalent; entry-level position
Work EnvironmentOffice-based, interacting with healthcare providers and insurance staffOffice-based, supporting provider networks and customer service
Employer & Industry UsageHealthcare insurance companies, managed care organizationsHealthcare insurance companies, managed care organizations
Common Search & ComparisonProvider Relations Representative Ii vs Provider Relations Representative IProvider Relations Representative I

The Provider Relations Representative II typically requires more experience and may handle more complex provider issues compared to the Provider Relations Representative I. Both roles are essential in maintaining provider networks within healthcare insurance companies, but the 'II' level often involves greater responsibilities and expertise.

More about Provider Relations Representative Ii jobs
What job categories do people searching Provider Relations Representative Ii jobs look for? The top searched job categories for Provider Relations Representative Ii jobs are:
Provider Relations Representative Ii jobs near you
Provider Relations Representative

Provider Relations Representative

University Health

San Antonio, TX • On-site

$20.30 - $33/hr

Full-time

Posted 23 days ago

University Of Nevada (Reno) rating

8.4

Company rating: 8.4 out of 10

Based on 15 frontline employees who took The Breakroom Quiz

75th of 535 rated colleges and universities

Job description

POSITION SUMMARY/RESPONSIBILITIES
Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network. This position will build and nurture positive relationships with health plan network participants by providing the on boarding orientation, and delivering guidance and high-quality service through regular engagement by phone and through scheduled in-person visits to targeted provider offices. This position will also coordinate with: Compliance & Quality staff on the re-credentialing process; with Provider Contracting staff for contracting issues or concerns; and will periodically assist the Claims staff with auditing and troubleshooting of provider data to ensure proper claims adjudication. The Provider Relations Representative knows and abides by all organizational and departmental policies, sets personal standards, and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.
EDUCATION/EXPERIENCE
A minimum of five years of related experience in the health care or managed care field of customer service-related work is required. Bachelor's degree in business, health care, communications, or other related area is preferred. Recent experience as a provider relations representative, member service representative, or relevant claim experience is highly preferred.
LICENSURE
Valid Texas driver's license as well as a reliable vehicle is required.

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