To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation • Contracting providers and essential vendors in current service ...
To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation • Contracting providers and essential vendors in current service ...
The Provider Relations Representative primarily handles communication and development for post-onboarding surgeon activities, and physician recruitment where applicable. One of the most important ...
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The Provider Relations Representative primarily handles communication and development for post-onboarding surgeon activities, and physician recruitment where applicable. One of the most important ...
The Provider Relations Representative is responsible for presenting, promoting, and resolving concerns and issues brought forward by providers and internal staff and develop, improve, and streamline ...
The Provider Relations Representative is responsible for presenting, promoting, and resolving concerns and issues brought forward by providers and internal staff and develop, improve, and streamline ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Provider Service Representative - Entry-Level (High School Graduate) This is an Onsite Position Position Summary: The Provider Relations Specialist serves as a key point of contact between healthcare ...
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Provider Service Representative - Entry-Level (High School Graduate) This is an Onsite Position Position Summary: The Provider Relations Specialist serves as a key point of contact between healthcare ...
Provider Service Representative - Entry-Level (High School Graduate) This is an Onsite Position Position Summary: The Provider Relations Specialist serves as a key point of contact between healthcare ...
Provider Service Representative - Entry-Level (High School Graduate) This is an Onsite Position Position Summary: The Provider Relations Specialist serves as a key point of contact between healthcare ...
Provider Relations Representative I
Eureka, CA · On-site
$72K - $90K/yr
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
Provider Relations Representative I
Eureka, CA · On-site
$72K - $90K/yr
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Represent Provider Relations in cross-department workflows and projects. * Ensureappropriate providerservices including working across departments to resolve issues. * Ensure assigned providers are ...
Represent Provider Relations in cross-department workflows and projects. * Ensureappropriate providerservices including working across departments to resolve issues. * Ensure assigned providers are ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Represent Provider Relations in cross-department workflows and projects. * Ensureappropriate providerservices including working across departments to resolve issues. * Ensure assigned providers are ...
Represent Provider Relations in cross-department workflows and projects. * Ensureappropriate providerservices including working across departments to resolve issues. * Ensure assigned providers are ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
... Rep Visit Sheet. * Investigates and responds to provider concerns. Serves as neutral liaison ... or public relations preferred, or equivalent combination of education and experience; prior ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Become a part of our caring community The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in ...
Provider Relations Representative information
See salary details
$13.94 - $16.46
6% of jobs
$16.46 - $18.97
3% of jobs
$18.97 - $21.48
13% of jobs
$22.11 is the 25th percentile. Wages below this are outliers.
$21.48 - $23.99
12% of jobs
$23.99 - $26.51
14% of jobs
The median wage is $26.81 / hr.
$26.51 - $29.02
22% of jobs
$30.22 is the 75th percentile. Wages above this are outliers.
$29.02 - $31.53
12% of jobs
$31.53 - $34.05
7% of jobs
$34.05 - $36.56
5% of jobs
$36.56 - $39.07
3% of jobs
$39.07 - $41.59
3% of jobs
$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 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 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?
| Aspect | Provider Relations Representative | Customer Service Representative |
|---|---|---|
| Credentials | High school diploma or equivalent; healthcare knowledge | High school diploma or equivalent; customer service skills |
| Work Environment | Healthcare offices, insurance companies | Call centers, retail, service industries |
| Employer & Industry | Health insurance, healthcare providers | Various industries including retail, telecom |
| Search & Comparison Intent | Understanding roles in healthcare insurance | Customer 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 cities are hiring for Provider Relations Representative jobs?
Cities with the most Provider Relations Representative job openings:
What are the most commonly searched types of Provider Relations Representative jobs?
The most popular types of Provider Relations Representative jobs are:
Who are the top companies hiring for Provider Relations Representative jobs?
The top employers for Provider Relations Representative jobs are:
What states have the most Provider Relations Representative jobs?
States with the most job openings for Provider Relations Representative jobs include:
What job categories do people searching Provider Relations Representative jobs look for?
The top searched job categories for Provider Relations Representative jobs are:
What are popular job titles related to Provider Relations Representative jobs?
For Provider Relations Representative jobs, the most frequently searched job titles are:
- provider relations specialist
- provider relations coordinator
- physician relations representative
- provider enrollment specialist
- physician relations specialist
- provider relations manager
- healthcare enrollment specialist
- patient relations representative
- healthcare representative
- insurance healthcare representative
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 22 days ago
Job description
American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations.
If you would like to be part of a collaborative, supportive and caring team, we look forward to receiving your application!
Benefits and Perks include:
- Affordable Medical/Dental/Vision insurance options
- Generous paid time-off program and paid holidays for full time staff
- TeleDoc 24/7/365 access to doctors
- Optional short- and long-term disability plans
- Employee Assistance Plan (EAP)
- 401K retirement accounts
- Employee Referral Bonus Program
ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation
• Contracting providers and essential vendors in current service areas to maintain CMS adequacy and providing necessary services in the care of the Plan members
• Insuring providers and essential vendors in current service areas meet the credentialing requirements for their appropriate service lines
• Educating providers on the Health Plan(s) functions and roles in caring for its membership
• Ongoing educational updates as prescribed by CMS and the Health Plan(s) policies
• To conduct the education presentations of the Health Plan(s) providers to insure their understanding and commitment with the Health Plan(s)
• Monitor, maintain and support provider relationships to insure network coverage in all areas
• To work with and be involved in implementation as needed
• Establish a positive work environment that encourages participation in process improvement and commitment to department/company success
• Complete corporate assignments as assigned
Required Skills:
• Must have knowledge and familiarity with all levels of medical services and ability to rapidly develop working relationships
• Must be able to accept instructions and work independently in the completions of goals and assignments
• Must have strong negotiation, organization, presentation and time management skills
• Must be able to effectively communicate with all levels of medical staff to explain Health Plan(s) program, benefits and goals
• Must be able to work effectively in a team environment
• Excellent computer skills, including Microsoft Office Suite
• Must be self-motivated, dependable, team and goal-oriented
Required Work Experience:
• Experience in the health care field required
• Prior experience in network development / network services is preferred
• Prior experience with acute and post-acute facilities is beneficial
• Prior experience with Medicare Advantage plans is helpful
Licensing/Certification/Education Requirements:
• Bachelor’s degree
Other Requirements:
• Must be available to work 8 a.m. until 5 p.m. local time
• Position requires travel to network provider locations.
• Teleworking is an option if criteria are met
EQUAL OPPORTUNITY EMPLOYER
Our Organization does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Organization will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made.
This employer participates in E-Verify.
About American Health Partners
Sourced by ZipRecruiter
American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Franklin, TN, US
Year founded
1976