Provider Services Advocate - Riverside/Corona

LSMA Management Inc; San Bernardino (CA); Hybrid; USD 46,000 - 50,000; Full time

Job summary

LSMA Management Inc. in California seeks a Provider Services Advocate to serve as the primary liaison between the IPA and its contracted provider network.

You will resolve inquiries, educate offices on processes (authorizations, referrals, claims, eligibility), and support operational performance across departments. The role involves routine clinic visits, potential travel within the assigned area, and building strong relationships to improve access, quality, and service for members and

Qualifications

• Minimum: 2+ years of experience in managed care, healthcare administration, MSO, IPA, medical group, health plan, or provider office environment.
• Preferred: Experience supporting provider relations, claims, credentialing, or health plan operations in California managed care.
• Any combination of education and work experience that would be equivalent to the stated minimum requirements would qualify for consideration.

Responsibilities

• Serve as primary liaison between the IPA and contracted provider network; resolve provider inquiries and educate offices on IPA processes.
• Support provider satisfaction and operational performance by addressing issues across internal departments and external partners.
• Conduct routine and as-needed clinic visits, including travel to assigned areas, to strengthen relationships and identify improvement opportunities.
• Assist with referrals, authorizations, claims/payments, and eligibility topics; ensure confidentiality and data integrity.

Skills

Provider relations

Customer service

Verbal communication

Problem solving

Analytical skills

Teamwork

Confidentiality

Office software

Healthcare knowledge

Education

High School diploma

Bachelor's degree in healthcare administration

Tools

Microsoft Office

Job description

Description

JOB SUMMARY

The Provider Services Advocate serves as a primary liaison between a California-based Independent Practice Association (IPA) and its contracted provider network (primary care, specialists, ancillary providers, and clinic staff). This role supports provider satisfaction and operational performance by resolving provider inquiries, educating offices on IPA processes (authorizations, referrals, claims/payment, eligibility, and delegated functions), and facilitating issue resolution across internal departments and external partners. The Advocate conducts routine and as-needed clinic visits - including travel to the assigned area - to strengthen relationships, reinforce standards, and identify improvement opportunities that enhance access, quality, and service.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: High School diploma or equivalent required.

Preferred: Bachelor's degree in healthcare administration, public health, or related field.

Experience

Minimum: 2+ years of experience in managed care, healthcare administration, MSO, IPA, medical group, health plan, or provider office environment.

Preferred: Experience supporting provider relations, claims, credentialing, or health plan operations. Experience working in California managed care environment. Experience working with MSO, IPA, or delegated managed care operations.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Skills, Knowledge & Abilities

• Knowledge of managed care operations, providers networks, and healthcare delivery systems.
• Knowledge of claims processing, eligibility, and credentialing processes.
• Knowledge of Medicare, Medi-Cal, Commercial, PPO, and HMO plan structures.
• Strong customer service and provider support skills.
• Excellent verbal and written communication skills.
• Strong problem-solving and analytical skills.
• Ability to manage multiple tasks and prioritize workload.
• Strong attention to detail and organizational skills.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Ability to maintain confidentiality and handle sensitive information.
• Ability to work independently and collaboratively in a team environment.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. Work is primarily performed in a standard office or hybrid office environment and requires prolonged periods of sitting, computer use, and telephone communication. The role requires sustained attention to detail, problem-solving, and multitasking to resolve provider issues efficiently. Occasional lifting or moving of materials up to approximately 15-20 pounds may be required. The position requires the ability to communicate effectively with providers, staff, and external partners while maintaining professionalism and confidentiality.

PAY RANGE

$33.65 - $36.06 / hourly