Health Care Service Corporation

Provider Relations Representative

Health Care Service Corporation$55K — $123K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree with 3 years in managed care or 5 years in the field.
  • 2 years in healthcare administration involving provider communication.
  • Strong interpersonal, analytical, and communication skills.
  • Familiarity with health care industry practices.
  • Willingness to travel regionally, including overnight stays.
  • Knowledge of reimbursement methods and claims processing systems.

Responsibilities

  • Enhance provider relationships through education and support.
  • Resolve claims issues and assist with provider concerns.
  • Foster positive interactions with facility and physician providers.
  • Educate providers on policies and reimbursement processes.
  • Support provider satisfaction and business improvements.

Benefits

  • Health and wellness benefits including a comprehensive health plan.
  • 401(k) savings and pension plan.
  • Paid time off and parental leave programs.
  • Disability insurance and supplemental life insurance.
  • Employee assistance program and tuition reimbursement.
  • Paid holidays and additional incentives.
Full Job Description
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.

Base Pay Range
$55,900.00 - $123,500.00

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

About Health Care Service Corporation

Health Care Service Corporation (HCSC) is the largest customer-owned health insurer in the United States. HCSC offers a wide variety of health insurance products and related services, through its operating divisions and subsidiaries in Illinois, Montana, New Mexico, Oklahoma and Texas. HCSC's headquarters is located in Chicago, Illinois.
Learn more about Health Care Service Corporation
Size
24,000 employees
Industry
Founded
1936

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