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Provider Specialist Jobs (NOW HIRING)

COWLITZ INDIAN TRIBE

Provider Specialist

Longview, WA · On-site

$34.35 - $41.25/hr

Provider Specialist DEPARTMENT: HHS - Child Care Development Program (CCDP) LOCATION: Longview, Washington REPORTS TO: Program Manager STATUS: Hourly; Full-Time WAGE RANGE: $34.35 - $41.25 per hour ...

Lowe's

PROvider Specialist

Mooresville, NC · On-site

$20.67 - $34.52/hr

Your Impact The PROvider Specialist is primarily responsible for completing specific activities in support of a defined PROvider Management model. This includes conducting business, and other ...

Lowe's

PROvider Specialist

Mooresville, NC · On-site

$20.67 - $34.52/hr

Your Impact The PROvider Specialist is primarily responsible for completing specific activities in support of a defined PROvider Management model. This includes conducting business, and other ...

Corp

Provider Specialist - ELRC 18

Philadelphia, PA · On-site

Provider Specialist The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This position is responsible for activities to ensure ...

New

PHMC

Provider Specialist - ELRC 18

Philadelphia, PA · On-site

The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This position is responsible for activities to ensure the full array of ...

PHMC

Provider Specialist - ELRC 18

Philadelphia, PA · On-site

The Provider Specialist performs core functions of the Provider Services Team at the Early Learning Resource Center (ELRC). This position is responsible for activities to ensure the full array of ...

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Provider Specialist information

See salary details

$31.5K

$69.7K

$133K

How much do provider specialist jobs pay per year?

As of Sep 9, 2026, the average yearly pay for provider specialist in the United States is $69,738.00, according to ZipRecruiter salary data. Most workers in this role earn between $47,500.00 and $84,500.00 per year, depending on experience, location, and employer.

What is a provider specialist?

A Provider Specialist is a professional who serves as a liaison between healthcare providers and insurance companies or healthcare networks. They are responsible for managing provider enrollment, credentialing, and maintaining up-to-date records to ensure compliance with regulations. Provider Specialists also handle inquiries related to provider contracts, reimbursement, and claims, supporting both providers and internal teams. Their work helps ensure that healthcare providers can deliver services efficiently within insurance or healthcare systems.

What are the key skills and qualifications needed to thrive as a provider specialist?

To thrive as a Provider Specialist, you need a strong understanding of healthcare administration, managed care processes, and provider relations, often supported by a relevant degree or experience in healthcare management. Familiarity with provider databases, credentialing systems, and health plan software such as CAQH or Facets is typically required. Excellent communication, problem-solving abilities, and attention to detail are vital soft skills for effectively supporting providers and resolving issues. These skills ensure efficient provider onboarding, compliance, and satisfaction, which are crucial for seamless healthcare operations.

What are some common challenges provider specialists face when coordinating between healthcare providers and insurance companies?

Provider Specialists often encounter challenges when ensuring accurate and timely communication between healthcare providers and insurance companies, especially regarding claims processing and credentialing. They may deal with discrepancies in documentation, varying policy requirements, and tight deadlines, which require strong attention to detail and problem-solving skills. Additionally, navigating frequent policy updates and building rapport with both internal teams and external partners are essential parts of the role. Overcoming these challenges helps Provider Specialists contribute to efficient healthcare operations and positive patient experiences.

What is the difference between Provider Specialist vs Medical Assistant?

AspectProvider SpecialistMedical Assistant
Required CredentialsCertification or training in healthcare administration or related fieldsPost-secondary education, certification often preferred
Work EnvironmentHealthcare facilities, clinics, hospitalsClinics, outpatient settings, hospitals
Employer & Industry UsageHealth insurance companies, healthcare providersMedical offices, clinics, hospitals
Common Search & Comparison IntentUnderstanding roles in healthcare administrationPatient care support roles

Provider Specialists focus on healthcare administration, insurance processing, and patient coordination, often working behind the scenes. Medical Assistants primarily support clinical tasks and patient care. While both work in healthcare settings, their roles and required credentials differ significantly.

More about Provider Specialist jobs

What cities are hiring for Provider Specialist jobs?

Cities with the most Provider Specialist job openings:

What states have the most Provider Specialist jobs?

States with the most job openings for Provider Specialist jobs include:

What are popular job titles related to Provider Specialist jobs?

For Provider Specialist jobs, the most frequently searched job titles are:

Provider Specialist jobs near you
Infographic showing various Provider Specialist job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 76% Full Time, 15% Part Time, and 6% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $69,738 per year, or $33.5 per hour.

Provider Specialist

Philadelphia, PA • On-site

Independence Blue Cross
Insurance Services • 1 - 5K employees
Learn more about Independence Blue Crossexternal

Other

Re-posted 16 days ago

Independence Blue Cross rating

8.8

Company rating: 8.8 out of 10

Based on 26 frontline employees who took The Breakroom Quiz

58th of 315 rated insurance

Job description

Provider Specialist

The Provider Specialist is responsible for troubleshooting issues, providing detailed information related to claims, coverage, and benefit plans, and ensuring provider concerns are resolved in a timely and efficient manner.

Key responsibilities include verifying provider credentialing for suspended claims; verifying professional and facility pricing; maintaining thorough and accurate documentation of all inquiries within designated tracking systems; and applying a working knowledge of provider support systems. The role supports providers across the Federal Employee Program (FEP); Local and Commercial PA and AHNJ plans; BlueCard; and Government markets.

Additionally, the position requires participation in special projects and work groups as assigned, as well as collaboration with internal teams to improve provider service processes. Other duties may be assigned as needed to support departmental and organizational goals.

Bachelor's degree in business, Health Care, or a related field/commensurate work experience. In lieu of a BS/BA degree, extensive experience and knowledge of (3-5 years) IBC's various operating systems is acceptable. In-depth knowledge of managed care and professional payment systems is preferred. A demonstrated knowledge of various operational departments including Claims, Medical Policy, Contracting, Specialty Programs, Benefits, and Network Services is preferred. The ideal candidate will be self-motivated, highly organized, detail-oriented, able to handle multiple high priorities, as well as possess above average problem solving, analytical and communication skills (both written and verbal). An established ability to interact with all levels of management is required. Proficiency with Excel and Access are required. Proficiency with Project is preferred.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

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