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Provider services representative vs call center representative

The differences between provider services representatives and call center 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 services representative and a call center representative. Additionally, a provider services representative has an average salary of $33,858, which is higher than the $31,549 average annual salary of a call center representative.

The top three skills for a provider services representative include customer service, data entry and patients. The most important skills for a call center representative are strong customer service, customer service, and patients.

Provider services representative vs call center representative overview

Provider Services RepresentativeCall Center Representative
Yearly salary$33,858$31,549
Hourly rate$16.28$15.17
Growth rate-4%-4%
Number of jobs252,118133,579
Job satisfaction-3
Most common degreeBachelor's Degree, 41%High School Diploma, 37%
Average age4040
Years of experience1212

What does a provider services representative do?

A provider services representative is responsible for supporting, developing, and maintaining service relationships with involved participants, including providers, physicians, and administrators. Your duties typically include responding to direct and electronic questions from clients about rates, policies, referrals, and eligibility, handling telephone calls for the provider and member inquiries, and resolving complaints by the member and member representative. In addition, you will be assisting in collecting supporting data and documentation about the member's care. You are also expected to conduct research to be able to provide a well-informed answer to members' inquiries.

What does a call center representative do?

Call center representatives are employees who take customer calls in the company's contact center. They answer incoming calls related to their account. Call center representatives are trained on the company's products, policies, and guidelines. They are expected to know the ins and outs of every company product under their account before they are assigned to the operations floor. Once they are deemed efficient enough to handle calls, they begin to take customer inquiries and try to resolve them during the call. Call center representatives are expected to follow company policies and procedures and to meet the goals set by the company.

Provider services representative vs call center representative salary

Provider services representatives and call center representatives have different pay scales, as shown below.

Provider Services RepresentativeCall Center Representative
Average salary$33,858$31,549
Salary rangeBetween $24,000 And $46,000Between $25,000 And $39,000
Highest paying CityNew York, NYSeattle, WA
Highest paying stateNew YorkWashington
Best paying companyOracleUniversity of California, Berkeley
Best paying industryHealth CareFinance

Differences between provider services representative and call center representative education

There are a few differences between a provider services representative and a call center representative in terms of educational background:

Provider Services RepresentativeCall Center Representative
Most common degreeBachelor's Degree, 41%High School Diploma, 37%
Most common majorBusinessBusiness
Most common college--

Provider services representative vs call center representative demographics

Here are the differences between provider services representatives' and call center representatives' demographics:

Provider Services RepresentativeCall Center Representative
Average age4040
Gender ratioMale, 22.2% Female, 77.8%Male, 27.4% Female, 72.6%
Race ratioBlack or African American, 11.5% Unknown, 5.1% Hispanic or Latino, 20.4% Asian, 6.4% White, 55.9% American Indian and Alaska Native, 0.7%Black or African American, 11.7% Unknown, 5.2% Hispanic or Latino, 20.6% Asian, 6.1% White, 55.7% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between provider services representative and call center representative duties and responsibilities

Provider services representative example 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.
  • Show more

Call center representative example responsibilities.

  • Manage Facebook and patient communication programs.
  • Provide member eligibility and referral status information to patients adhering to HIPAA guidelines.
  • Follow all current Medicare, Medicaid and commercial insurance regulations and requirements to ensure continual compliance.
  • Document all relevant information regarding patients and providers while abiding by all HIPAA and associate patient confidentially requirements.
  • Navigate several screens and windows.
  • Install windows, doors, cabinets, flooring.
  • Show more

Provider services representative vs call center representative skills

Common provider services representative skills
  • Customer Service, 24%
  • Data Entry, 6%
  • Patients, 5%
  • Medicaid, 5%
  • Health Insurance, 4%
  • Appeals, 3%
Common call center representative skills
  • Strong Customer Service, 80%
  • Customer Service, 4%
  • Patients, 2%
  • Data Entry, 2%
  • Troubleshoot, 1%
  • Inbound Phone Calls, 1%

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