Provider relations representative vs service representative

The differences between provider relations representatives and service representatives can be seen in a few details. Each job has different responsibilities and duties. It typically takes 6-12 months to become both a provider relations representative and a service representative. Additionally, a provider relations representative has an average salary of $40,957, which is higher than the $33,692 average annual salary of a service representative.

The top three skills for a provider relations representative include customer service, provider relations and medicaid. The most important skills for a service representative are customer service, client service, and patients.

Provider relations representative vs service representative overview

	Provider Relations Representative	Service Representative
Yearly salary	$40,957	$33,692
Hourly rate	$19.69	$16.20
Growth rate	-4%	-4%
Number of jobs	203,893	210,671
Job satisfaction	-	5
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 51%
Average age	40	40
Years of experience	12	12

What does a provider relations representative do?

Provider relations specialists are professionals who work for insurance companies as the primary contact for health care providers such as clinics and hospitals. These specialists are required to provide answers about service contracts and billing procedures to health care providers. They must handle the documents of patients to ensure that proper paperwork has been filed for coverage while developing communications with providers about any policy changes. Provider relations specialists must also travel to different health care organizations to provide training to their staff on insurance policies and procedures.

What does a service representative do?

Service representatives handle customer inquiries, requests, complaints, and other general feedback. They are usually the first point of contact with the company's customers. Service representatives are expected to be familiar with all of the company's products so that they can answer all inquiries made by the customers. They should also be familiar with company policies and guidelines on sales and customer handling so that they can address concerns and feedback. They are usually the ones who try to resolve customer complaints by sending issues to applicable departments and ensuring that customers are satisfied with the company's products and services.

Provider relations representative vs service representative salary

Provider relations representatives and service representatives have different pay scales, as shown below.

	Provider Relations Representative	Service Representative
Average salary	$40,957	$33,692
Salary range	Between $30,000 And $55,000	Between $24,000 And $45,000
Highest paying City	Helena, MT	New York, NY
Highest paying state	Montana	New York
Best paying company	Parkland Hospital	Northern Trust
Best paying industry	Health Care	Government

Differences between provider relations representative and service representative education

There are a few differences between a provider relations representative and a service representative in terms of educational background:

	Provider Relations Representative	Service Representative
Most common degree	Bachelor's Degree, 58%	Bachelor's Degree, 51%
Most common major	Business	Business
Most common college	-	-

Provider relations representative vs service representative demographics

Here are the differences between provider relations representatives' and service representatives' demographics:

	Provider Relations Representative	Service Representative
Average age	40	40
Gender ratio	Male, 24.2% Female, 75.8%	Male, 39.6% Female, 60.4%
Race ratio	Black or African American, 12.1% Unknown, 5.3% Hispanic or Latino, 21.8% Asian, 6.5% White, 53.7% American Indian and Alaska Native, 0.7%	Black or African American, 11.0% Unknown, 5.3% Hispanic or Latino, 20.6% Asian, 6.8% White, 55.7% American Indian and Alaska Native, 0.7%
LGBT Percentage	7%	7%

Differences between provider relations representative and service representative duties and responsibilities

Provider relations representative example responsibilities.

Help manage ACO program and review measures with provider offices.
Advise clients on health care and manage care products including POS, PPO and medical management programs.
Provide keen oversight in developing and maintaining quality improvement programs while managing payroll.
Manage software maintenance renewal partner and assist with upselling additional and higher functionality licenses to increase revenue.
Review the provider contracts, paid members claims, base on the CPT code & ICD-9 that are submitted.
Review provider claims for CPT and ICD-9 coding accuracy and generate payment of claims base upon current fee schedule.

Service representative example responsibilities.

Utilize QuickBooks to manage patient's payment for hearing aids and various equipment.
Join online marketplace specializing in local deals to manage customer engagements while providing industry-best service.
Manage customer relations with internal personnel, group administrators, brokers and members as related to Medicare insurance.
Involve great interpersonal skills and upselling.
Provide excellent customer service via ZenDesk e-mail platform.
Counsele individuals who are applying for or receiving TANF.

Provider relations representative vs service representative skills

Common provider relations representative skills

Customer Service, 16%
Provider Relations, 9%
Medicaid, 9%
Patients, 6%
Health Plan, 5%
PowerPoint, 4%

Common service representative skills

Customer Service, 9%
Client Service, 8%
Patients, 7%
PET, 5%
Front Desk, 5%
Veterans, 5%

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Office and Administrative Industry
Provider Relations Representative
Provider Relations Representative vs Service Representative

Updated January 8, 2025

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