Provider Relations Representative

Health Care Service Corporation

. Provide support to contracted providers .

Posted 11/3/2026full-timeSpringfield • Illinois • United StatesMid-LevelSenior💰 $63,300 - $114,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Medicaid and Medicare business processes, provider education, and operational support, while effectively managing provider relationships and resolving issues. Strong analytical and communication skills are essential for ensuring compliance with contractual and financial requirements.

Highest-signal resume keywords

Medicaid Business Process KnowledgeMedicare Business Process KnowledgeHealth Care Administration ExperienceClaims Processing Systems KnowledgeProvider Communication Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider EducationOperational SupportContract KnowledgeReimbursement Methods UnderstandingAnalytical Skills

Soft Skills

Effective Communication SkillsOrganizational SkillsCollaboration SkillsPresentation SkillsInitiative

Tools & Technologies

WordExcelPowerPoint

Industry Keywords

Managed CareHealth Care IndustryProvider Issues ResolutionFinancial RequirementsService Excellence

About the role

Key responsibilities & impact

Provide support to contracted providers
Develop and maintain cooperative working relationships with providers
Facilitate and enhance providers’ ease of doing business with HCSC
Track and resolve provider issues
Educate and train providers
Identify trends and evaluate providers to ensure contractual and financial requirements are met
Support medical insurance and claims-related inquiries
Use Medicaid and Medicare business-process knowledge to resolve issues and provide education
Address provider requests across a national scope
Promote consistent service and operational excellence

Requirements

What you’ll need

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
Demonstrated knowledge of Medicaid and Medicare business processes, including provider education and operational support
Knowledge of the health care industry
Ability and willingness to travel within assigned areas, 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, interpersonal, presentation, and communication skills
Ability to take initiative and work independently
Demonstrated ability to meet deadlines and work well under pressure
Collaboration skills resulting in business/process improvements/changes
PC experience and skills including Word, Excel, and PowerPoint
Facilitation, presentation, and analytical skills
Sponsorship is not available

Benefits

Comp & perks

Curated development plans and professional development
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
Other incentives
Annual incentive bonus plan