Provider Relations Representative

Health Care Service Corp.; Albuquerque (NM); Hybrid; USD 56,000 - 124,000; Full time

Benefits offered by this job

Health benefits

401(k) savings plan

Pension plan

Paid time off

Paid parental leave

Disability insurance

Life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Job summary

Health Care Service Corporation is seeking a Provider Relations professional to enhance relationships with facility and physician providers, 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. This Flex position requires 3 days in office and 2 days work from home.

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.
• Ability and willingness to travel within assigned areas for responsibility, 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.
• Analytical skills.
• Ability to take initiative and work independently.
• Clear and concise interpersonal, verbal and written communication skills.
• Collaboration skills for business/process improvements.

Responsibilities

• Enhance relationships with facility and physician providers and act as liaison through education, training, claims assistance, issue resolution, and provider service.
• Support provider understanding of policies, procedures, and reimbursement processes.
• Foster positive provider relationships and satisfaction.
• Travel as required within assigned areas, including overnight stays.

Skills

Interpersonal skills

Analytical skills

Presentation skills

Communication skills

Provider reimbursement knowledge

Travel willingness

PC skills (Word, Excel, PowerPoint)

Education

Bachelor's degree

Tools

Word

Excel

PowerPoint

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 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.
• Effective interpersonal, analytical, presentation and 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 of provider 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, verbal and written communication skills.
• Collaboration skills resulting in business/process improvements/changes.
• PC experience and skills to include Word, Excel, PowerPoint, etc.
• Facilitation, presentation and 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.

• 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

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 plan subject to the terms and the conditions of the plan.

Base Pay Range $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location.

Employment Statement

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.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

HCSC is an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned.