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Provider Relations Representative Jobs in California

Corvel

Provider Relations Sp I

Folsom, CA · On-site

$13.38 - $23.42/hr

The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling ...

Corvel

Provider Relations Sp I

Folsom, CA · Remote

$13.38 - $23.42/hr

The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling ...

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All JobsProvider Relations Representative JobsProvider Relations Representative Jobs in California

Provider Relations Representative information

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$13

$27

$41

How much do provider relations representative jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for provider relations representative in California is $27.52, according to ZipRecruiter salary data. Most workers in this role earn between $22.07 and $31.06 per hour, depending on experience, location, and employer.

What is a provider relations representative?

Provider Relations Representatives are professionals who serve as the main point of contact between healthcare providers, such as doctors or clinics, and health insurance companies or managed care organizations. They handle inquiries, resolve issues, and ensure that providers understand and comply with policies, procedures, and contractual obligations. Their role is crucial in maintaining positive relationships, addressing concerns, and facilitating smooth communication to improve patient care and provider satisfaction.

What does a provider relations representative do?

A provider relations representative works for a health care agency and is the primary liaison between their company and health care providers, such as medical doctors and dentists. As a provider relations representative, your specific job duties vary, depending on your employer. But your responsibilities may include answering questions from doctor’s offices about benefit verification, entering claims data for processing, and maintaining a good relationship with providers. To become a provider relations representative, you need a high school diploma or equivalent, though many employers prefer candidates with an associate or bachelor’s degree in a health care related field and industry experience.

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

To thrive as a Provider Relations Representative, you need a solid understanding of healthcare policies, contract negotiation, and customer service, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with claims processing systems, CRM software, and provider databases is typically required. Strong interpersonal, problem-solving, and conflict resolution skills help you build effective relationships with healthcare providers. These skills and qualities are essential for ensuring provider satisfaction, resolving issues efficiently, and maintaining strong network partnerships.

What are some common challenges provider relations representatives face when working with healthcare providers, and how can they be addressed?

Provider Relations Representatives often encounter challenges such as resolving complex contract issues, addressing provider concerns about claims processing, and navigating changing healthcare regulations. Building strong communication skills and maintaining up-to-date knowledge of company policies can help address these challenges effectively. Proactively engaging with providers, listening to their feedback, and collaborating with internal departments are key strategies for fostering positive relationships and ensuring provider satisfaction.

What is the difference between Provider Relations Representative vs Customer Service Representative?

AspectProvider Relations RepresentativeCustomer Service Representative
CredentialsHigh school diploma or equivalent; healthcare knowledgeHigh school diploma or equivalent; customer service skills
Work EnvironmentHealthcare offices, insurance companiesCall centers, retail, service industries
Employer & IndustryHealth insurance, healthcare providersVarious industries including retail, telecom
Search & Comparison IntentUnderstanding roles in healthcare insuranceCustomer support roles across industries

The Provider Relations Representative focuses on managing relationships with healthcare providers and ensuring compliance with insurance policies, often working within healthcare or insurance companies. In contrast, a Customer Service Representative handles general customer inquiries, support, and issue resolution across various industries. While both roles require strong communication skills, the Provider Relations Representative specializes in healthcare provider interactions, making it a more industry-specific position.

More about Provider Relations Representative jobs

What are the most commonly searched types of Provider Relations Representative jobs in California?

The most popular types of Provider Relations Representative jobs in California are:

What are popular job titles related to Provider Relations Representative jobs in California?

For Provider Relations Representative jobs in California, the most frequently searched job titles are:

What job categories do people searching Provider Relations Representative jobs in California look for?

The top searched job categories for Provider Relations Representative jobs in California are:

What cities in California are hiring for Provider Relations Representative jobs?

Cities in California with the most Provider Relations Representative job openings:

What are popular job titles related to Provider Relations Representative jobs in CA?

For Provider Relations Representative jobs in CA, the most frequently searched job titles are:

Provider Relations Representative jobs near you
Infographic showing various Provider Relations Representative job openings in California as of August 2026, with employment types broken down into 100% Full Time. Highlights an 60% In-person, and 40% Remote job distribution, with an average salary of $57,252 per year, or $27.5 per hour.

Provider Relations Representative I

Western Health Advantage

Sacramento, CA • On-site

$22 - $24/hr

Full-time

Posted 20 days ago

Job description

Provider Relations Representative I

Western Health Advantage
Location: Sacramento, CA (Hybrid)
Salary: $22.00 – $24.00 hourly
"Purpose that inspires. Impact that improves lives. Join us in building healthier communities." 
Western Health Advantage

Western Health Advantage is seeking a Provider Relations Representative I to support accurate and compliant provider data management. This role is ideal for someone who enjoys data-focused work, problem-solving, and collaborating across teams in a healthcare environment.

What You’ll Do

  • Maintain and update provider data (additions, terminations, changes) with strong accuracy

  • Manage and respond to time-sensitive emails and requests

  • Research and resolve provider data discrepancies and issues

  • Support provider reporting, including monthly and quarterly deliverables

  • Provide and manage access to eligibility systems for providers

  • Assist with system testing (Facets) and website updates

Collaborate with internal teams, provider groups, and vendors
What You'll Bring

  1. Associate’s degree in Business Administration or related field

  • 2+ years of healthcare experience (HMO preferred)

  • Strong attention to detail and ability to manage multiple priorities

  • Intermediate skills in Excel, Word, email, and database systems

  • Experience with Facets is a plus
     

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law. (EOE)

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.

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