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Provider Relations Representative Jobs in Virginia

GDIT

Provider Data Representative

Falls Church, VA · Remote

$46K - $62K/yr

The Representative partners with Provider Relations, Credentialing, Provider Data, Claims Operations, and Contracting to keep provider information complete, accurate, timely, and compliant with ...

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GDIT

Provider Data Supervisor

Falls Church, VA · On-site

This role leads a team of Provider Data Representatives to maintain accurate provider demographic ... The Supervisor partners closely with Provider Relations, Contracting, Credentialing, Claims ...

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How much do provider relations representative jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for provider relations representative in Virginia is $27.65, according to ZipRecruiter salary data. Most workers in this role earn between $22.16 and $31.20 per hour, depending on experience, location, and employer.

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 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 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.

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.
More about Provider Relations Representative jobs
What are the most commonly searched types of Provider Relations Representative jobs in Virginia? The most popular types of Provider Relations Representative jobs in Virginia are:
What are popular job titles related to Provider Relations Representative jobs in Virginia? For Provider Relations Representative jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Provider Relations Representative jobs in Virginia look for? The top searched job categories for Provider Relations Representative jobs in Virginia are:
What cities in Virginia are hiring for Provider Relations Representative jobs? Cities in Virginia with the most Provider Relations Representative job openings:
What are popular job titles related to Provider Relations Representative jobs in VA? For Provider Relations Representative jobs in VA, the most frequently searched job titles are:
Provider Relations Representative jobs near you
Infographic showing various Provider Relations Representative job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $57,514 per year, or $27.7 per hour.

Patient Relations Representative

Chesapeake Regional Healthcare

Chesapeake, VA • On-site

$13.50 - $17.50/hr

Full-time

Posted 20 days ago

Chesapeake Regional Healthcare rating

6.9

Company rating: 6.9 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

Job description

Summary
The Patient Relations Representative (PRR) serves as a highly visible member of the Patient Experience Team to cover the experience needs of patients, families, staff and physicians for the day hours. The PRR has a primary focus of Guest Relations and staff support duties as they pertain to the Patent Experience in the Emergency Department as well as the overall hospital. The PRR is responsible to provide accurate data collection and complaint follow up during their work hours. The PRR interacts with visitors, patients' families, staff and physicians by ascertaining their needs and supporting/directing them accordingly.
Essential Duties and Responsibilities
These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned:
  • Responsible for assisting with patient concerns in the ED and acute care areas, as well as concerns that arrive either online or by phone. Listens, evaluates, and diffuses situations.
  • Retains accurate information when hearing a complaint.
    • Directs patient concerns to the appropriate department.
    • Ability to make decisions with confidence regarding case sensitive issues.
    • Makes every reasonable attempt to satisfactorily resolve the patient concern.
    • Able to determine when supervisory input is necessary in decision making.
  • Works independently within the hours assigned. Makes autonomous decisions based on standards and policy.
  • Provides advocate support for issues as part of the Patient Experience Team.
  • Capable of being an expert for the NRC Satisfaction Survey system to teach and support managers and educate staff.
  • Demonstrates a commitment to flexible work scheduling when necessary to ensure excellent patient experience.
  • Maintain confidentiality within and outside the department at all times.
  • Ability to prioritize workload and ensure back-up coverage, if needed.
  • Participates as the primary contact for the Patient Experience hotline.
  • Is willing to perform other appropriate duties as the job necessitates.
  • Attempts to resolve all concerns prior to patient's discharge when applicable.
  • Assures other departments are notified of discharge needs that patient voices as a concern.
  • Attend required hospital-wide orientations, meetings, and in-services.
  • Proficient computer skills required. Microsoft Office, Excel, and RL6 database preferred.
  • Addresses walk-in visits from patients and their families.
    • Responds to calls regarding patient/families that present to Administration or facility entrance desks per the protocol that is in place for response time and action.
    • Keeps Patient Experience Director and team members informed of pertinent circumstances.
  • Answers the telephone in a courteous manner.
    • Screens calls tactfully and triages messages according to the degree of urgency.
    • Checks voice mail as requested and relays information to Patient Experience team members as appropriate.
  • May assist to prepare accurate monthly, quarterly, and yearly reports of patient concerns/grievances for Patient Experience Team, Managers, and Senior leadership.
  • Is part of the Patient Experience Team and will participate in the patient experience improvement projects when requested by supervisor.
  • Provides support to families, physicians, and hospital staff.
    • Uses negotiation skills to reasonably respond to customer demands.
    • Maintains courteous composure and decisiveness in an effort to diffuse angry, aggressive patients, families, and visitors.
  • Exhibits excellent customer services to patients, visitors, physicians, and co-workers.
    • Shows courtesy, compassion and respect to others in adherence to the hospital policy for promoting a positive work and customer environment.
  • Maintains excellent relations with nurses, physician staff, and other hospital personnel through frequent contact and interactions.
  • Assists with educating new employees in techniques to provide quality customer service, service recovery.
  • Enter patient concerns received from phone, in person or electronically into system database.
  • Additional duties as assigned.

Supervisory Responsibilities
None
Accountability Responsibilities
Reports to: Director Patient Experience
Responsibilities:
As noted in this document and is accountable for the advocacy and support of Patient Experience, and Patient Satisfaction in acute care areas and the Emergency Department.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
  • Minimum Required Education: High school diploma and 3 years work experience in a customer service capacity.
  • Exhibits unique skills acquired through training or education, and life experience, for the health care setting.
    • Applicants should have experience in all of the following:

      • Public contact in a service organization, preferably health care
      • Education in Ethical Resolution a plus
      • Computer data entry under a Windows Operating System

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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