Hybrid Provider Relations Specialist

HCSC Group; Jacksonville (IL); Hybrid; USD 63,000 - 114,000; Full time

Benefits offered by this job

Flex in-office 3 days / 2 days WFH

Job summary

HCSC is seeking a Provider Relations Specialist to support contracted providers and streamline interactions with HCSC on a national scale. The role focuses on issue tracking, education, training, and evaluating providers to ensure contractual and financial requirements are met, with emphasis on reliable service and operational excellence.

The position requires healthcare administration experience, knowledge of Medicaid/Medicare processes, and the ability to travel.

Qualifications

• Bachelor’s degree and 3+ years in managed care, or 5+ years in a managed care environment.
• 2+ years of health care administration experience with direct provider communication.
• Knowledge of Medicaid and Medicare processes, including provider education and operational support.
• Strong interpersonal, analytical, presentation and communication skills.
• Willingness to travel, including overnight stays.
• Knowledge of contracts, products and provider reimbursement methods.
• Experience with claims processing systems.
• Proficient in Word, Excel and PowerPoint.

Responsibilities

• Support providers on medical insurance and claims-related inquiries.
• Develop and maintain cooperative relationships with contracted providers.
• Facilitate and enhance provider’s ease of doing business with HCSC.
• Track issues, provide education and training, identify trends and evaluate providers for compliance.

Skills

Interpersonal skills

Analytical skills

Presentation skills

Communication skills

Training skills

Team collaboration

Ability to take initiative

Deadline management

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

HCSC is seeking a Provider Relations Specialist to support contracted providers and streamline interactions with HCSC on a national scale. The role focuses on issue tracking, education, training, and evaluating providers to ensure contractual and financial requirements are met, with emphasis on reliable service and operational excellence.

The position requires healthcare administration experience, knowledge of Medicaid/Medicare processes, and the ability to travel.