Provider Relations Representative (Healthcare)

Location: Springfield, Illinois, United States; hybrid schedule with in-office visibility required three days per week and work from home two days per week. Relocation is not available.

Base pay: $55,900–$123,500 annually, plus eligibility for an annual incentive bonus.

Company

hirify.global provides health insurance and manages Blue Cross contracted provider networks across multiple lines of business.

What you will do

• Manage contracting, credentialing, provider data maintenance, and network compliance activities.
• Build and maintain relationships with hospitals, physicians, surgery centers, behavioral health facilities, VA hospitals, and other contracted providers.
• Serve as an escalation point for operational, claims, reimbursement, policy, procedure, and contractual issues.
• Research provider concerns, coordinate claims and payment issue resolution, and track recurring pain points.
• Lead internal and external provider meetings, seminars, presentations, training, and education.
• Document provider interactions and resolutions in Salesforce and support projects by tracking milestones, timelines, and cross-functional activities.

Requirements

• Bachelor’s degree and three years of managed care experience, or at least five years of managed care experience.
• Two years of healthcare administration experience in clinical and financial settings with direct provider communication.
• Knowledge of healthcare systems, payer/provider dynamics, provider reimbursement methodologies, claims, contracts, and applications.
• Strong analytical, interpersonal, presentation, facilitation, research, organizational, and communication skills.
• Ability to travel within assigned areas, including overnight stays, work independently, meet deadlines, and operate effectively under pressure.
• PC proficiency, including Word, Excel, and PowerPoint.

Nice to have

• Advanced Excel skills, including pivot tables, data validation, and handling large data sets.
• Familiarity with claims, billing, CPT, and ICD-10 coding basics.
• Experience with CRM or provider management systems, IAMHP affiliation, or work with government agencies, legislative, and advocacy groups.

Culture & Benefits

• Curated development plans and professional growth opportunities.
• Health and wellness benefits, 401(k) savings plan, pension plan, paid time off, and paid parental leave.
• Disability insurance, supplemental life insurance, employee assistance program, and paid holidays.
• Tuition reimbursement and additional incentives.
• Visa sponsorship is not available now or in the future.