How to hire a provider services representative

How to hire a provider services representative, step by step

Here's a step-by-step provider services representative hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a provider services representative job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new provider services representative
• Step 8: Go through the hiring process checklist

What does a provider services representative do?

Post a provider services representative job for free, promote it for a fee

Post free

1. Identify your hiring needs

   The provider services representative hiring process starts by determining what type of worker you actually need. Certain roles might require a full-time employee, whereas part-time workers or contractors can do others.

   Determine employee vs contractor status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   A provider services representative's background is also an important factor in determining whether they'll be a good fit for the position. For example, provider services representatives from different industries or fields will have radically different experiences and will bring different viewpoints to the role. You also need to consider the candidate's previous level of experience to make sure they'll be comfortable with the job's level of seniority.

   The following list breaks down different types of provider services representatives and their corresponding salaries.

   Type of Provider Services Representative	Description	Hourly rate
   Provider Services Representative	Customer service representatives interact with customers to handle complaints, process orders, and provide information about an organization’s products and services.	$11-22
   Call Center Representative	Call center representatives are employees who take customer calls in the company's contact center. They answer incoming calls related to their account... Show more	$12-18
   Enrollment Representative	An enrollment representative directly communicates with clients when it comes to enrollment programs. Although their duties vary on their place or industry of employment, it typically includes helping enrollees understand the program requirements and rules, reaching out to enrollees to provide updates, gathering and processing applications, answering inquiries, and collecting payments when necessary... Show more	$12-18

   Show more

2. Create an ideal candidate profile

   Common skills:

   • Customer Service
   • Data Entry
   • Patients
   • Medicaid
   • Health Insurance
   • Appeals
   • CPT
   • HIPAA
   • Medical Terminology
   • Inbound Calls
   • Fee Schedules
   • Claims Processing
   • Customer Inquiries
   • Provider Inquiries

   Check all skills

   Responsibilities:

   • Coach, evaluate and performance manage MSRs to ensure timely and accurate service to clients.
   • Achieve excellent customer satisfaction ratings as documented by CIGNA surveys.
   • Proof reading contracts in order to adjust claims according to proper DRG, ICD-9, and CPT codes.
   • Complete the surgery schedule and ensure all patients are aware of their financial responsibility prior to the surgery date.
   • Help providers with all information about CPT codes such as authorizations, restrictions, fee schedules, and correct diagnosis codes.
   • Register patients for surgery in computer system.

   More provider services representative duties

3. Make a budget

   Including a salary range in your provider services representative job description is one of the best ways to attract top talent. A provider services representative can vary based on:

   • Location. For example, provider services representatives' average salary in arkansas is 42% less than in new york.
   • Seniority. Entry-level provider services representatives 48% less than senior-level provider services representatives.
   • Certifications. A provider services representative with certifications usually earns a higher salary.
   • Company. Working for an established firm or a new start-up company can make a big difference in a provider services representative's salary.

   Average provider services representative salary

   $16.28hourly

   $33,858 yearly

   ---

   Entry-level provider services representative salary

   $24,000 yearly salary

   Updated December 5, 2025

   Average provider services representative salary by state

   Rank	State	Avg. salary	Hourly rate
   1	New York	$45,865	$22
   2	Massachusetts	$39,920	$19
   3	Maryland	$38,604	$19
   4	Iowa	$38,050	$18
   5	Pennsylvania	$38,045	$18
   6	Delaware	$37,479	$18
   7	Connecticut	$37,416	$18
   8	Montana	$37,289	$18
   9	Washington	$37,186	$18
   10	New Hampshire	$36,812	$18
   11	California	$36,672	$18
   12	Rhode Island	$35,044	$17
   13	Minnesota	$34,323	$17
   14	Oregon	$33,862	$16
   15	Ohio	$33,628	$16
   16	Illinois	$33,411	$16
   17	Michigan	$32,839	$16
   18	Nebraska	$32,532	$16
   19	Arizona	$32,482	$16
   20	North Dakota	$32,302	$16

   Average provider services representative salary by company

   Company

   Rank	Company	Average salary	Hourly rate	Job openings
   1	Oracle	$47,965	$23.06	189
   2	Blue Cross and Blue Shield of Louisiana	$38,574	$18.55
   3	PacificSource Health Plans	$38,321	$18.42
   4	VIVA USA	$37,129	$17.85
   5	BlueCross BlueShield of South Carolina	$36,114	$17.36	4
   6	Centers Plan For Healthy Living	$35,043	$16.85
   7	MetroPlus	$34,654	$16.66	3
   8	HCSC	$34,128	$16.41	11
   9	Highmark	$34,114	$16.40	162
   10	Molina Healthcare	$33,787	$16.24	837
   11	CHS	$33,541	$16.13	1
   12	Banner Health	$32,882	$15.81	38
   13	MJHS Health System	$32,834	$15.79	6
   14	Tenet Healthcare	$32,757	$15.75	122
   15	Kelly Services	$32,681	$15.71	61
   16	Heart of Ohio Family Health	$32,537	$15.64
   17	ICONMA	$32,537	$15.64
   18	Martin's Point Health Care	$32,512	$15.63	3
   19	The-Panther-Group	$32,429	$15.59	5
   20	Child Care Solutions	$32,315	$15.54

4. Writing a provider services representative job description

   A provider services representative job description should include a summary of the role, required skills, and a list of responsibilities. It's also good to include a salary range and the first name of the hiring manager. To help get you started, here's an example of a provider services representative job description:

   Provider services representative job description example

   Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
   KNOWLEDGE/SKILLS/ABILITIES
   This role serves as the primary point of contact between Molina Health plan and the Provider community that serves Molina members. It's an external-facing, field-based position requiring a high degree of job knowledge, communication, and organizational skills to successfully engage high volume, high visibility providers (including senior leaders and physicians) to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership.
   
   Under minimal direction, works directly with the Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service.
   Conducts regular provider site visits within assigned region/service area. Determines own daily or weekly schedule, as needed to meet or exceed the Plan's monthly site visit goals. A key responsibility of the Representative during these visits is to proactively engage with the provider and staff to determine, for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
   Provides on-the-spot training and education as needed, which may include counseling providers diplomatically, while retaining a positive working relationship.
   Independently troubleshoots problems as they arise, making an assessment when escalation to a Senior Representative, Supervisor, or another Molina department is needed. Takes initiative in preventing and resolving issues between the provider and the Plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
   Initiates, coordinates, and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians. Such meetings would occur to discuss and resolve issues related to utilization management, pharmacy, quality of care, and correct coding, for example.
   Independently delivers training and presentations to assigned providers and their staff, answering questions that come up on behalf of the Health plan. May also deliver training and presentations to larger groups, such as leaders and management of provider offices (including large multispecialty groups or health systems, executive level decision makers, Association meetings, and JOC's).
   Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives. Examples of such initiatives include administrative cost effectiveness, member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider Website, etc.).
   Trains other Provider Services Representatives as appropriate.
   Role requires 80%+ same-day or overnight travel. (Extent of overnight travel will depend on the specific Health Plan and its service area.).
   
   JOB QUALIFICATIONS
   Required Education
   Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.
   Required Experience
   
   2 - 3 years customer service, provider service, or claims experience in a managed care setting.
   Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for service, capitation, and various forms of risk, ASO, etc.
   
   Preferred Education
   Bachelor's Degree.
   Preferred Experience
   
   5 years' experience in managed healthcare administration and/or Provider Services.
   5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.
   
   
   To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
   Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
   #PJHPO

   Copy this example

   

5. Post your job

   There are various strategies that you can use to find the right provider services representative for your business:

   • Consider promoting from within or recruiting from your existing workforce.
   • Ask for referrals from friends, family members, and current employees.
   • Attend job fairs at local colleges to find candidates who meet your education requirements.
   • Use social media platforms like LinkedIn, Facebook, and Twitter to reach potential job candidates.

   Post your job online:

   • Post your provider services representative job on Zippia to find and recruit provider services representative candidates who meet your exact specifications.
   • Use field-specific websites.
   • Post a job on free websites.

6. Interview candidates

   During your first interview to recruit provider services representatives, engage with candidates to learn about their interest in the role and experience in the field. During the following interview, you'll be able to go into more detail about the company, the position, and the responsibilities.

   It's also good to ask about candidates' unique skills and talents. You can move on to the technical interview if a candidate is good enough for the next step.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new provider services representative

   Once you've selected the best provider services representative candidate for the job, it's time to write an offer letter. In addition to salary, this letter should include details about the benefits and perks you offer the candidate. Ensuring that your offer is competitive is essential, as qualified candidates may be considering other job opportunities. The candidate may wish to negotiate the terms of the offer, and you should be open to discussion. After you reach an agreement, the final step is formalizing the agreement with a contract.

   It's equally important to follow up with applicants who don't get the job with an email letting them know that the position has been filled.

   Once that's done, you can draft an onboarding schedule for the new provider services representative. Human Resources should complete Employee Action Forms and ensure that onboarding paperwork is completed, including I-9s, benefits enrollment, federal and state tax forms, etc. They should also ensure that new employee files are created for internal recordkeeping.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

   Sign up to download full list

   Sign up

How much does it cost to hire a provider services representative?