Provider Relations Representative

Posted 3 Days Ago
Be an Early Applicant
Albuquerque, NM, USA
In-Office
56K-124K Annually
Senior level
Healthtech • Insurance
The Role
Builds and maintains relationships with physician and facility providers, serving as a liaison for education, training, claims assistance, issue resolution, reimbursement processes, and ongoing provider service. The role supports provider understanding of policies and procedures, identifies recurring concerns, promotes satisfaction, and contributes to operational improvements. It requires managed care and healthcare administration experience, strong communication and analytical skills, knowledge of reimbursement and claims systems, and travel within assigned areas.
Summary Generated by Built In

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.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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 plan subject 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.

Skills Required

  • Bachelor’s degree and 3 years of work experience in managed care, or at least 5 years of work experience in a managed care environment
  • At least 2 years of healthcare administration experience in clinical and financial settings
  • Direct provider communication experience
  • Effective interpersonal, analytical, presentation, and communication skills
  • Knowledge of the healthcare industry
  • Willingness and ability to travel within assigned areas, 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
  • Ability to take initiative and work independently
  • Ability to meet deadlines and work well under pressure
  • Clear and concise verbal and written communication skills
  • Collaboration skills supporting business and process improvements
  • PC skills, including Microsoft Word, Excel, and PowerPoint
  • Facilitation, presentation, and analytical skills
  • Experience supporting provider relationships in a managed care, health plan, hospital, or physician practice environment
  • Knowledge of provider office workflows, practice operations, and healthcare administrative processes
  • Customer service and provider relationship management experience
  • Ability to identify trends and recurring provider concerns
  • Ability to prioritize multiple assignments while maintaining accuracy and attention to detail

Health Care Service Corporation Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Health Care Service Corporation and has not been reviewed or approved by Health Care Service Corporation.

  • Retirement Support — A pension plan alongside a matching 401(k) is offered, an uncommon combination in the private sector. This combination is described as a standout element that helps retain employees.
  • Healthcare Strength — Healthcare options are broad, with multiple medical, dental, and vision choices, wellness incentives, and access to resources like on-site fitness centers and an EAP. These offerings add meaningful value beyond base pay.
  • Parental & Family Support — Paid parental leave (up to six weeks at full pay after one year), adoption assistance, and mothers’ rooms are available. These supports reinforce family needs alongside work commitments.

Health Care Service Corporation Insights

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The Company
HQ: Chicago, IL
13,563 Employees

What We Do

Imagine Something New, Something Different. Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families. HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development. HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC. Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization. Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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