224 provider relations representative jobs at 148 companies in United States
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Provider Relations Representative
Miami Lakes, Florida, United States
OnsiteFull Time
ClareMedica Health Partners: Private Florida primary-care provider delivering coordinated, value-based care to Medicare Advantage members and other patients.
2+ YOEBachelor’s degree; 2+ years in provider relations; fluent English and Spanish; strong communication/interpersonal and organizational skills.
Assembly Health: Private healthcare-services providing RCM and operational support to physician practices and care communities.
Medical billing or healthcare provider relations experience; enrollment or credentialing preferred; customer service and claims resolution experience; Microsoft Office Suite proficiency; strong communication and reporting skills.
Boynton Beach or Palm Beach County or Broward County
FieldFull Time
Medical Specialists of the Palm Beaches (MSPB): Private multispecialty physician group providing value-based care to patients in Palm Beach and Broward counties.
High school diploma required; associate or bachelor's degree preferred. Requires healthcare, customer service, or provider relations experience, communication, analytical, project management, and Microsoft Office skills.
Microsoft Office, Microsoft Excel, Microsoft Word, Microsoft Access, Zoom, Microsoft Teams, Webex
General Dynamics Information TechnologyNew York Stock Exchange: GD: Provider of enterprise IT services and defense solutions.
3+ YOERequires 3+ years of related experience, business operations, data ingestion, problem-solving, reporting management, provider relationship management, onboarding, issue resolution, and cross-functional collaboration.
HumanaNYSE: HUM: Health insurance and care services provider.
2+ YOERequires Illinois residency, 2+ years of healthcare or managed care provider experience, LTSS provider experience, relationship management, complex issue resolution, presentations, and managed care contract knowledge.
HS1 Medical Management: Specialty benefits manager for health plans covering therapy, eye care, dermatology, and podiatry.
2+ YOEAssociate degree or equivalent and 2–3 years of experience in a physician office, HMO, managed care, or healthcare environment; provider contracting or network management experience preferred.
General Dynamics Information TechnologyNew York Stock Exchange: GD: Provider of enterprise IT services and defense solutions.
3+ YOERequires 3+ years of related experience, business operations, data ingestion, problem solving, and reporting management skills. U.S. citizenship is not required.
American Health Plans: Private healthcare serving seniors through Medicare Advantage plans, care coordination, psychiatric hospitals, and long-term-care pharmacy services.
Bachelor's degree and healthcare experience required. Requires provider payment methodology knowledge, negotiation, presentation, organization, communication, computer, and independent work skills; network services experience preferred.
EMI Health: Nonprofit health insurance organization providing medical, dental, vision, and telemedicine benefits to employers, public-sector groups, and individuals.
1+ YOEPreferred 1+ year in healthcare contracting or provider offices; requires Arizona residency, travel comfort, strong communication, relationship-building, organization, independence, customer service, and Microsoft Office proficiency.
Doctors HealthCare Plans: Florida-based, locally owned Medicare Advantage health plan serving eligible Medicare beneficiaries.
3+ YOERequires 3–5 years with a Medicare Advantage health plan or a BS/BA degree, strong communication and organization, regulatory knowledge, provider reimbursement expertise, customer service, and initiative management skills.
SKYGEN: Private dental and vision benefits administrator and SaaS provider serving payers, providers, government agencies, and members.
3+ YOEBachelor's degree or equivalent experience, 3–5 years in provider relations, account management, or managed care, strong communication and strategic thinking, and intermediate Microsoft Office skills.
Microsoft Word, Microsoft Excel, email, Dental Hub, Enterprise System
Independent Health: Independent Health is a not-for-profit health plan providing insurance and benefits to Western New York members.
Prior customer service experience in healthcare preferred; high school diploma/GED; knowledge of CPT/ICD/HCPCS coding, strong communication, problem-solving, and multitasking skills.
Molina Healthcare of South Carolina, Inc.NYSE: MOH: Provider of managed healthcare services for government-sponsored programs.
3+ YOERequires 3+ years of customer service, provider services, or claims experience in managed care or a medical office, healthcare delivery knowledge, presentation experience, and Microsoft Office proficiency.
Electronic Medical Records (EMR), Centers for Medicare and Medicaid Services (CMS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), Electronic Data Interchange (EDI), Microsoft Office
Blue Shield of California: Nonprofit California health plan providing insurance coverage to individuals, families, employers, and public-program members.
5+ YOERequires a bachelor's degree or high school/GED plus 4 years of relevant experience, 5 years of prior relevant experience, health plan experience, California provider network experience, and regulatory knowledge preferred.
Health Care Service Corporation: Customer-owned mutual health insurer serving employers, individuals, and government-program members through Blue Cross and Blue Shield plans.
3+ YOEBachelor's degree and 3 years of managed care experience, or 5 years in managed care; 2 years of healthcare administration and provider communication experience, plus healthcare, claims, contracts, analytical, presentation, and communication skills.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Salesforce, GUI, PPW
Western Health Advantage: Nonprofit HMO health plan providing affordable medical coverage to Northern California individuals, families, employers, and Medicare beneficiaries.
2+ YOEAssociate degree in business or related field, 2+ years healthcare experience (HMO preferred), intermediate Microsoft Excel/Word and database skills, attention to detail, multitasking, experience with Facets a plus.
Medical Professionals of Miami: Miami cancer-care clinics providing personalized treatment for cancer patients through board-certified oncology specialists.
Bachelor's degree or equivalent experience, 5+ years in healthcare business development, physician liaison, or oncology marketing. Requires Florida driver's license, reliable transportation, local daily travel, and oncology care knowledge.
ProviDRs Care: Physician-owned Kansas PPO network serving employers, payers, providers, and communities with healthcare network and cost-containment solutions.
High school diploma or GED required; 1–2 years of customer service, healthcare administration, medical office, or insurance experience preferred. Requires communication, organization, computer, and listening skills.
Microsoft Word, Microsoft Excel, Microsoft Outlook