Provider Relations Representative

HCSC • Albuquerque, NM

6d • Hybrid

About The Position

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.

Requirements

• 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

Nice To Haves

• 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

Responsibilities

• Enhancing relationships with facility and physician providers
• Serving as a liaison through education, training, claims assistance, issue resolution, and ongoing provider service
• Supporting provider understanding of policies, procedures, and reimbursement processes
• Fostering positive provider relationships and satisfaction

Benefits

• 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
• Annual incentive bonus plan

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level