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Provider Specialist information

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$31.5K

$69.7K

$133K

How much do provider specialist jobs pay per year?

As of Sep 10, 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.

IDD Provider Specialist

Ennis, TX • On-site

Lakes Regional Community Center
Offices of Mental Health Practitioners • 201 - 500 employees
Learn more about Lakes Regional Community Centerexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 14 days ago

Lakes Regional Community Center rating

8.8

Company rating: 8.8 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

The IDD Provider Specialist position is responsible for group and individualized activities at the Individualized Skills and Socialization (ISS) and/or residential settings program, and also provides direct care services to persons with developmental disabilities. Responsibilities include:
  • Implementation and evaluation of therapeutic programs for individuals with intellectual and developmental disabilities, planning individual activities
  • Liaison with individual's Provider Care Coordinators, and family members.
  • Daily completion of documentation of services, complying with safety procedures and assist with monitoring facility and vehicle maintenance.
  • Serves as a member of the interdisciplinary team, as requested.
  • Provides direct care services to include assistance and training with personal hygiene, food preparation, feeding, mobility, community access, recreation, leisure activities, and maintenance of basic health care needs.
  • Provision of training and assistance with all activities of daily living, including administration and monitoring of medications, housekeeping, transportation, and other individualized goals.
  • Implements behavior management programs, and provides emergency behavior or health-related interventions, as necessary.
  • Fosters a productive, clean, comfortable, and safe environment for individuals; and serves as a positive role model for those we serve.

Other Requirements:
  • Must be able to assess and evaluate classroom effectiveness and implement changes as indicated.
  • Must have six months of any type of work experience.
  • Must be knowledgeable of therapeutic techniques and modalities of working with individuals with intellectual and developmental disabilities.
  • Exercise independent judgment, be able to work with minimal supervision and communicate effectively with individuals and co-workers.
  • Prefer working computer skills including MS Word and Excel.

Work Hours: 7 AM - 3 PM Monday - Friday
Employee Benefits at Full-Time Include:
  • Employer-Cost Sharing of Health Insurance (Plus 50% of Elected Dependent Coverage)
  • Employer-Paid Short-Term Disability Insurance
  • Employer-Paid Term Life Insurance
  • Loan Forgiveness Program
  • Pet Insurance
  • Employee Assistance Program
  • Employer-Match Retirement Contributions (Up to 5% of Base Salary)
  • Optional Dental, Vision, Life and Long-Term Disability Insurance
  • Wellness Program
  • 13 Paid Holidays per Year
  • 2 Weeks Paid Vacation Leave per Year with Graduating Accrual Rate
  • 2+ Weeks Paid Sick Leave per Year
  • Tuition discounts for select Colleges

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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