Provider Relations Representative

HCSC Group; Albuquerque (NM); Hybrid; USD 56,000 - 124,000; Full time

Job summary

Health Care Service Corporation is seeking a provider relations liaison to enhance relationships with facility and physician providers. The role educates, trains, assists with claims, resolves issues, and maintains ongoing provider service to improve satisfaction.

Qualified candidates will have a bachelor’s degree with managed care experience or equivalent, plus health care administration experience and strong communication skills, and must be able to travel as required.

Qualifications

• Bachelor’s degree and 3 years of work experience in managed care, or a minimum of 5 years’ work experience in a managed care environment.
• Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
• Excellent interpersonal, analytical, presentation and communication skills.
• Knowledge of the health care industry.
• Willingness to travel, including overnight stays.
• Knowledge of contracts, applications, and products.
• Understanding of provider reimbursement methods.
• Working knowledge of claims processing systems.
• Strong organizational and planning skills.
• Ability to work independently and meet deadlines under pressure.

Responsibilities

• Enhance relationships with facility and physician providers and serve as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service.
• Support provider understanding of policies, procedures, and reimbursement processes while fostering positive provider relationships and satisfaction.

Skills

Interpersonal skills

Analytical skills

Presentation skills

Communication skills

Word

Excel

PowerPoint

Travel readiness

Provider reimbursement knowledge

Claims processing systems

Contract knowledge

Organizational planning

Education

Bachelor’s degree

Managed care experience 3+ years

Health care admin exp 2+ years

Tools

Claims processing systems

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for enhancing relationships with facility and physician providers and serving as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service. The role supports provider understanding of policies, procedures, and reimbursement processes while fostering positive provider relationships and satisfaction.

Required Job Qualifications:

• Bachelor’s degreeand3years of work experience in managed care, or aminimum of5years’work experience in a managed care environment.
• Minimum of 2 years of health care administration experience in clinical and financial settings, with direct provider communication experience.
• Effective interpersonal, analytical,presentationand communication skills.
• Knowledge of the health care industry.
• Ability and willingness to travel within assigned areas for responsibility, including overnight stays.
• Knowledge of contracts, applications, and products.
• Understanding ofprovider reimbursement methods.
• Working knowledge of claims processing systems.
• Effective organizational and planning skills.
• Analytical skills.
• Ability to take initiative and work independently.
• Demonstrated ability to meet deadlines and work well under pressure.
• Clear and concise interpersonal,verbaland written communication skills.
• Collaborationskills resulting in business/process improvements/changes.
• PC experience and skillsto includeWord, Excel, PowerPoint, etc.
• Facilitation,presentationand analytical skills.

Preferred Qualifications

• Experience supporting provider relationships within a managed care, health plan, hospital, or physician practice environment.
• Knowledge of provider office workflows, practice operations, and healthcare administrative processes.
• Strong customer service mindset with a focus on provider satisfaction and relationship management.
• Ability to identify trends and recurring provider concerns to support operational improvements.Demonstrated ability to prioritize multiple assignments while maintaining accuracy and attention to detail.

This is a Flex position that requires 3 days in office and 2 days work from home.

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$55,900.00 - $123,500.00

Exact compensation may vary based on skills, experience, and location.