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Provider Services Representative Jobs (NOW HIRING)

w3r Consulting

Provider Services Representative

El Paso, TX · On-site

$32K - $43K/yr

Maintain accuracy of provider information in core internal and member facing systems. Requires frequent contact with our provider partners to confirm the accuracy of information provided with 95% or ...

w3r Consulting

Provider Services Representative

Chicago, IL · On-site

$41K - $56K/yr

Maintain accuracy of provider information in core internal and member facing systems. Requires frequent contact with our provider partners to confirm the accuracy of information provided with 95% or ...

VIVA USA INC

Provider Services Representative

Chicago, IL · On-site +1

$41K - $56K/yr

Maintain accuracy of provider information in core internal and member facing systems. Requires frequent contact with our provider partners to confirm the accuracy of information provided with 95% or ...

MJHS

Provider Services Representative

Manhattan, NY

$40K - $43K/yr

Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high ...

Kore1

Provide Services Representative

Rancho Cucamonga, CA

$16.25 - $22.25/hr

KORE1, a nationwide provider of creative and information technology recruiting, has an immediate opening for a Contract Medical Provider Services Representative for a large healthcare organization in ...

Centris

Lead Services Representative

Omaha, NE · On-site

Lead Services Representative (Assistant Manager) Hours : 40 hours per week (primarily 8:45am-5:45pm ... Provide unparalleled service to both internal and external members in accordance with the Centris ...

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All JobsProvider Services Representative Jobs

Provider Services Representative information

See salary details

$29.5K

$48.3K

$78.5K

How much do provider services representative jobs pay per year?

As of Jul 27, 2026, the average yearly pay for provider services representative in the United States is $48,284.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,000.00 and $57,000.00 per year, depending on experience, location, and employer.

What are Provider Services Representatives?

Provider Services Representatives are professionals who serve as the main point of contact between healthcare providers (such as doctors, hospitals, and clinics) and health insurance companies. They help resolve provider inquiries related to claims, benefits, eligibility, authorizations, and network participation. Their role ensures smooth communication and understanding between providers and insurers, ultimately helping patients receive the care they need. Provider Services Representatives may also assist with provider education and support efforts to improve provider satisfaction.

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

AspectProvider Services RepresentativeCustomer Service Representative
CredentialsHigh school diploma or equivalent; healthcare knowledge often preferredHigh school diploma or equivalent; general customer service skills
Work EnvironmentHealthcare offices, insurance companies, provider networksRetail, call centers, various industries
Employer & IndustryHealthcare, insurance providersVarious sectors including retail, telecom, finance
Common Search IntentUnderstanding healthcare provider support rolesGeneral customer support roles

The Provider Services Representative primarily works within healthcare and insurance settings, focusing on supporting healthcare providers and managing provider-related inquiries. In contrast, a Customer Service Representative handles a broader range of customer inquiries across multiple industries. While both roles require strong communication skills, Provider Services Representatives often need healthcare knowledge and familiarity with insurance processes, making their role more specialized within the healthcare industry.

What are some of the most common challenges faced by Provider Services Representatives, and how can they be managed effectively?

Provider Services Representatives often encounter challenges such as resolving complex provider inquiries, navigating frequent updates to healthcare policies, and balancing a high volume of calls or cases. Successful representatives manage these challenges by staying up-to-date with policy changes through regular training, leveraging internal resources for quick issue resolution, and developing strong communication skills to clearly explain procedures to providers. Building collaborative relationships with other departments, such as claims or credentialing teams, also helps streamline the resolution process and enhances overall service quality.

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

To thrive as a Provider Services Representative, you need strong knowledge of healthcare policies, insurance processes, and customer service, often supported by a relevant associate degree or healthcare administration experience. Familiarity with claims processing systems, medical billing software, and CRM platforms is typically required. Excellent communication, problem-solving, and organizational skills help you manage provider inquiries and resolve issues efficiently. These skills ensure accurate information exchange, provider satisfaction, and smooth operations within healthcare organizations.
More about Provider Services Representative jobs
What cities are hiring for Provider Services Representative jobs? Cities with the most Provider Services Representative job openings:
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What states have the most Provider Services Representative jobs? States with the most job openings for Provider Services Representative jobs include:
What job categories do people searching Provider Services Representative jobs look for? The top searched job categories for Provider Services Representative jobs are:
Provider Services Representative jobs near you
Infographic showing various Provider Services Representative job openings in the United States as of July 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% In-person job distribution, with an average salary of $48,284 per year, or $23.2 per hour.

Provider Services Representative

Triton Health Systems

Birmingham, AL

$16 - $19/hr

Full-time

Posted 3 days ago

Job description

Provider Services Representative

Location: Birmingham, Alabama

Job Summary

The Provider Services Representative serves as the primary contact for the participating provider network in building and maintaining relationships and acts as an advocate for the Health Plan. This position will travel to locations within the VIVA HEALTH service area through a reliable means of transportation insured in accordance with Company policy.

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

  • Comprehensive Health, Vision, and Dental Coverage
  • 401(k) Savings Plan with company match and immediate vesting
  • Paid Time Off (PTO)
  • 9 Paid Holidays annually plus a Floating Holiday to use as you choose
  • Tuition Assistance
  • Flexible Spending Accounts
  • Healthcare Reimbursement Account
  • Paid Parental Leave
  • Community Service Time Off
  • Life Insurance and Disability Coverage
  • Employee Wellness Program
  • Training and Development Programs to develop new skills and reach career goals
  • Employee Assistance Program

See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

Key Responsibilities

  • Serve as primary contact for issues between providers and Health Plan developing rapport with established and prospective providers to build business relationships.
  • Maintain documentation of provider visits and interactions in database.
  • Develop and conduct programs to ensure providers know and understand health plan business policies and practices as described in Policies and Practices.
  • Coordinate with other departments to ensure effective communication and/or coordination of efforts concerning provider issues and projects. Complete Provider File Maintenance (PFM) forms to update provider information in computer systems.
  • Assist with provider credentialing and re-credentialing efforts.
  • Work with Network Development and Marketing and Sales to ensure network adequacy.
  • Assist in updating provider-related materials.
  • Educate providers and staff on changes to the Health Plan.

REQUIRED QUALIFICATIONS:

  • Bachelor’s Degree or equivalent experience in provider relations or similar field
  • 2 years’ experience in customer service, marketing, or working with/in a physician’s office
  • Proficient in standard Microsoft Office software
  • Ability to organize ideas and communicate messages through various mediums including group presentations appropriate to listeners and situations
  • Valid driver's license in good standing
  • May require significant face-to-face member contact with duties regularly
    performed away from the principal place of business
  • Willing to submit to vaccine testing and screening

PREFERRED QUALIFICATIONS:

  • Bachelor’s Degree in a health-related field
  • 3 years’ experience in insurance claims, physician’s office, customer service, or marketing