Provider Relations Representative Job Description

A Provider Relations Representative is someone that works specifically with providers to ensure that the organization is meeting its contractual agreements with them.

Provider Relations Representatives are the people inside of the company responsible for assuring that partners are meeting agreed upon response times for inquiries, billing, and service requests.

Provider Relations Representatives are part of a larger group of people that fall under the category of provider relations.

These professionals work with providers and suppliers to ensure that there are agreements in place and that partners are fulfilling their obligations.

Updated on:     
September 15, 2022

Job Brief:

We're looking for a Provider Relations Representative to join our team. In this role, you will be responsible for developing and maintaining relationships with our provider network. You will also be responsible for ensuring provider compliance with our policies and procedures. If you are a people-person with great communication skills, then we want you on our team!

Provider Relations Representative Duties:

  • Maintain positive relationships with physicians, nurses, and other healthcare providers through effective communication, facilitating medical office operations, and identifying opportunities for process improvement
  • Manage provider relations from intake and scheduling through post-service and billing
  • Provide timely, accurate, and accurate information to providers regarding patient financial responsibility
  • Providing effective management of provider relations activities by regularly reviewing and updating standard operating procedures
  • Proactively identifying issues and opportunities to improve provider relations
  • Maintain compliance with federal and state regulations
  • Proficient in Microsoft Office and EHR software
  • Ensures proper and complete utilization of the EHR system

Provider Relations Representative Responsibilities:

  • Make outbound calls, emails and SMS messages to healthcare providers to capture their interest in our service, answer questions, and facilitate enrollment
  • Provide customer support via phone, email, and online, and answer billing questions, including submitting change requests, processing future payments, and resolving errors
  • Research data, analyze trends, and prepare reports, including monthly and quarterly revenue projections
  • Act as a liaison with third-party vendors, including medical suppliers and payers, and insurance carriers
  • Participate in national events, including trade shows and national conferences
  • Assist in designing, developing and maintaining operational processes
  • Research market trends and opportunities for growth, including new service lines, and medical specialties
  • Provide accurate, timely, and relevant information to internal and external customers
  • Act as single point of contact for escalated service requests

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Requirements And Skills:

  • Bachelor’s degree preferred; 2+ years’ proven experience in provider relations
  • Experience in process improvement, budget development, and customer service
  • Intermediate to advanced proficiency in Microsoft Office (Word, Excel, Outlook)
  • Ability to work independently, prioritize tasks

At Company Name, we value diversity and inclusion. We are an Equal Opportunity Employer and welcome applications from all people, regardless of race, religion, national origin, gender, sexual orientation, gender identity, gender expression, or age. We are especially committed to building a diverse and inclusive team and encourage applications from veterans and individuals with disabilities.

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