Cambia Health Solutions
Cambia Health Solutions Don’t just choose a career. Choose a career that makes a difference.
5d Career Job
  • Provider Relations Representative

    Job Locations US-OR-Portland
    Requisition ID 2019-26012 Category (Portal Searching) Provider Services/Network
  • Overview

    Provider Representative

    Portland, Oregon



    At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.

    Responsibilities & Requirements

    The Provider Representative serves as a liaison with contracted health care providers to assist in managing provider relationships. In addition you will:

    • Respond to provider inquiries by answering questions and helping them address issues or concerns.
    • Support Provider Consultants and Provider Contracting Executives as needed to ensure effective provider partnerships (e.g. gather data, update systems, research issues).
    • Resolve provider issues in order to build and maintain positive provider relationships that foster a collaborative approach to quality care, network stability and cost containment.

     Key Qualifications and Experience

    • In-depth understanding of medical terminology, CPT, HCPCS, ICD coding and experience related to the use of RBRVS.
    • Knowledge of managed care and Medicare concepts.
    • General computer skills including use of Microsoft Office products or equivalent software and ability to learn corporate software programs.
    • Ability to communicate effectively, both orally and in writing, regarding complex or sensitive information or issues, including ability to remain composed in confrontation situations.
    • Ability to establish and maintain effective professional relationships with customers.
    • Demonstrated analytical ability to identify problems, develop solutions, and implement chosen course of action.
    • Use good judgment and intelligent reasoning including ability to deal with complex topics.
    • Provider Representative would have a Bachelor’s Degree in healthcare, business or related field and 3 years’ experience in a related healthcare role or equivalent combination of education and
      experience.Ability to prioritize workload and focus on highest priorities.


    About Us

    Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.


    Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.


    If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.


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    Cambia Health Solutions
    Don’t just choose a career. Choose a career that makes a difference.

    Cambia Health Solutions, headquartered in Portland, Oregon, is dedicated to transforming health care. We put people at the heart of everything we do as we work to make the health care system better and more economically sustainable for people and their families. Our company reaches more than 70 [...]

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