How to Become a Provider Relations Representative
Step 1: Understand the job description and responsibilities of a Provider Relations Representative
What does a Provider Relations Representative do?
A Provider Relations Representative supports, develops and maintains service relationships with all participants (physicians, providers and administrators) of a provider network. Responds to electronic and direct inquiries from clients about policies, rates, changes, referrals, eligibility, credentialing, etc. May provide guidance or expertise to less experienced representatives. Being a Provider Relations Representative typically requires a bachelor's degree. Typically reports to a supervisor or manager. The Provider Relations Representative gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Relations Representative typically requires 2 to 4 years of related experience.
Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.
Customer service representatives typically do the following.
Customer service representatives answer questions or requests from customers or the public.
The specific duties of customer service representatives vary by industry.
For example, representatives who work in banks may answer customers’ questions about their accounts.
Step 2: Learn best tips to become a Provider Relations Representative
Best tips for those who want to become a Provider Relations Representative
Here are some tips to become a Provider Relations Representative.
Step 3: View best colleges and universities for Provider Relations Representative
Best colleges and universities for Provider Relations Representative
- Butler University
- Carroll College
- Cooper Union
- High Point University
- Princeton University
- Providence College
Step 4: Think about whether is it worth to be a Provider Relations Representative
Is being a Provider Relations Representative Worth it?
Job Summary This position responds to and resolves advanced to complex level issues related to the daily administration and operation of potential and existing providers and may involve provider education, interpreting and developing policies, procedures and guidelines.
This includes, but is not limited to coordinating orientation and education of providers, hospitals and the organizations insurance plan administration staff.
Maintains all levels of communication with network providers, informing them of any operational, procedural, and contractual changes and updates.
Assists manager with network development in various geographic regions within the organization, negotiates, implements and maintains managed care contracts with payers and providers.
PROVIDER RELATIONS REPRESENTATIVE Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care.
Step 5: Prepare relevant skills for being a Provider Relations Representative
What skills do you need to be a Provider Relations Representative?
Management often looks to professional level roles for execution on their visions and goals, as such some specific skills are required. The workload of this role requires knowledge of: Provider Management. If you highlight these skills during your interview process, you will be more likely to land the job!
CCPN is committed to developing and implementing a robust provider relations team and strategy state-wide with the understanding that provider relations staff….
One to two years provider relations experience interacting and problem-solving with providers.
Experience educating health care providers, establishing contractual agreements, coordinating and conducting provider recruitment preferred.
Strong customer service focus and customer relations skills.
Established and fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on site enrollment opportunities for marketing.
Step 6: View average salary for Provider Relations Representative
How much does a Provider Relations Representative make?
The average salary range for a Provider Relations Representative is from $64,177 to $78,447. The salary will change depending on your location, job level, experience, education, and skills.
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Average salary for Provider Relations Representative jobs
- Provider Relations Representative, Sr.
- Managed Care Provider Relations Manager
- Provider Network Administrative Representative