Post job

Provider services representative vs customer service representative

The differences between provider services representatives and customer 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 services representative and a customer service representative. Additionally, a provider services representative has an average salary of $33,858, which is higher than the $32,260 average annual salary of a customer service representative.

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

Provider services representative vs customer service representative overview

Provider Services RepresentativeCustomer Service Representative
Yearly salary$33,858$32,260
Hourly rate$16.28$15.51
Growth rate-4%-4%
Number of jobs252,118209,515
Job satisfaction-4
Most common degreeBachelor's Degree, 41%High School Diploma, 33%
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 customer service representative do?

Customer service representatives are the first point of contact of the customers, acting as the frontiers of the company and help in driving customer loyalty and retention by leaving a great impression and resolving all of their concerns. They accommodate customer queries by providing useful and comprehensive information about any products or services. Some would use that as an opportunity to market and promote more sales. The most challenging issues they use to handle are customer complaints and processing of refunds and returns. They also assist in basic troubleshooting or accounts and payment setup with the use of specific guidelines or step by step procedures. At most, they help and solve customer issues on their own, but sometimes they would need support from supervisors or other departments.

Provider services representative vs customer service representative salary

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

Provider Services RepresentativeCustomer Service Representative
Average salary$33,858$32,260
Salary rangeBetween $24,000 And $46,000Between $25,000 And $41,000
Highest paying CityNew York, NYDes Moines, WA
Highest paying stateNew YorkWashington
Best paying companyOracleOracle
Best paying industryHealth CareInsurance

Differences between provider services representative and customer service representative education

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

Provider Services RepresentativeCustomer Service Representative
Most common degreeBachelor's Degree, 41%High School Diploma, 33%
Most common majorBusinessBusiness
Most common college--

Provider services representative vs customer service representative demographics

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

Provider Services RepresentativeCustomer Service Representative
Average age4040
Gender ratioMale, 22.2% Female, 77.8%Male, 30.5% Female, 69.5%
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, 11.6% Unknown, 5.2% Hispanic or Latino, 21.2% Asian, 6.3% White, 55.0% American Indian and Alaska Native, 0.7%
LGBT Percentage7%7%

Differences between provider services representative and customer service 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

Customer service representative example responsibilities.

  • Manage and plan escalations; assure HIPPA guidelines are followed for confidentially and privacy.
  • Maintain cleanliness and safety and assist patients as necessary.
  • Operate POS system and maintain exceptional and consistent customer service.
  • Exercise proofreading and basic math skills to maintain quality control over documents process
  • Work in customer service department entering information into customer relationship management (CRM).
  • Develop highly empathetic client relationships and earn reputation for exceeding good customer service rep goals.
  • Show more

Provider services representative vs customer service representative skills

Common provider services representative skills
  • Customer Service, 24%
  • Data Entry, 6%
  • Patients, 5%
  • Medicaid, 5%
  • Health Insurance, 4%
  • Appeals, 3%
Common customer service representative skills
  • Cleanliness, 10%
  • POS, 7%
  • Data Entry, 6%
  • Sales Floor, 6%
  • Customer Service, 5%
  • Home Health, 5%

Browse office and administrative jobs