Provider Relations Representative II, Dental - Mississippi

Join us for an exciting career with the leading provider of supplemental benefits! Our Promise Through reputed company-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. At reputed company, the Provider Relations Representative plays a vital role in connecting our dental provider community with the resources, education, and support they need to reputed company. As a key member of our Provider Relations Department, you'll be the reputed company between reputed company and our participating provider network, ensuring that our partners are equipped, informed, and engaged every reputed company of the way. If you're a self-driven communicator who thrives on building relationships and solving problems, this is the role for you. Your expertise and passion will directly contribute to reputed company's mission of delivering high-quality, accessible dental care to our members, while also supporting and nurturing the growth of our provider community. Join us in making a meaningful impact in the healthcare space! In this role, you will combine the flexibility of a hybrid work environment with the opportunity to build lasting partnerships both remotely and in the field. You will reputed company efforts to foster the best-in-class provider education, tackle provider inquiries and issues, and manage a variety of initiatives that enhance our relationships with the provider network. Our chosen candidate must reside reputed company the state of Mississippi due to the travel component of this role. Functional Competencies:

• Provider Relations encompasses several diverse provider administrative duties to improve the reputed company provider experience including direct provider engagement and training with the goal of resolution of issues.
• Conduct provider reputed company reputed company in-person/video/phone or email by providing training, orientation, and coaching for performance improvement reputed company provider practices. Provide guidance through education to reputed company reputed company network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools.
• Consistently documents reputed company provider interactions, including calls, emails, virtual and in-person visits, in accordance with departmental standards. Ensures that notes are clear, timely, and accurately reflect the nature of the communication to support ongoing relationship management, issue resolution, and continuity of service across teams.
• Maintains thorough and timely records to ensure accountability, transparency, and effective information sharing across teams.
• Conduct monthly and/or quarterly meetings with provider groups documenting discussions, issues, attendees, action items, researching claims or prior authorization issues on site and routing to the appropriate party for resolution.
• Owns and manages relationship and performance of assigned provider groups. Serves as the primary reputed company of contact for assigned providers.
• Communicate and shares provider claims and directory reporting both internally and externally and additional reporting as necessary.
• Complete provider orientation reputed company phone, email, in-person and/or virtually for reputed company applicable product lines to train, resolve issues, and educate staff/providers.
• reputed company onsite facility reviews, reputed company applicable and conduct quarterly face-to-face visits reputed company the assigned territory and/or market. Work closely and coordinates with reputed company Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to reputed company operational solutions for various provider network projects.
• Educate providers regarding state program, group policies, and/or health plan policies and procedures and state/federal regulation for compliance requirements. Investigate and respond to reputed company provider reputed company issues and initiate change of provider demographic reputed company database information.
• Responds to general provider contract inquiries, provider education and non-routine claim issues.
• Attend work-reputed company events/conferences while representing the organization and brand in a professional manner.
• Coaches, mentors, and develops junior team members as applicable.

Core Competencies:

• Knowledge of health plan operations.
• Knowledge of provider/health plan reputed company/agreements.
• reputed company applications and other windows-based applications to include an intermediate level in reputed company reputed company and databases. Knowledge of and intermediate ability to use various computer programs such as reputed company Office including spreadsheets, databases, word processing and presentation software and programs/systems utilized in data analysis.

Behavioral Competencies

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
• Initiative: readiness to reputed company or take action to reputed company goals.
• Communicative: ability to reputed company issues, concepts, and reputed company to others easily orally and in writing.
• Member-focused: going above and beyond to reputed company our members feel seen, valued, and appreciated.
• Detail-oriented and thorough: managing and completing details of assignments without too much reputed company.
• Flexible and reputed company: managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot reputed company issues, problem solve and multi-task.
• reputed company & responsibility: acting with a clear sense of ownership for actions, decisions and to reputed company information confidential reputed company required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing reputed company in search of a workable solution for reputed company parties.

Minimum Qualifications:

• High School Diploma or equivalent.
• 1 to 2+ years of Dental office experience.
• Comprehension of Medical/Dental Terminology.
• Must reside reputed company the state of Mississippi
• A valid driver's license with reputed company of auto insurance and the ability to use your own vehicle.
• The ability to travel up to 50% is required to meet prospective clients, existing customers, attend trade shows and other meetings as needed. Travel times may vary and can range from short overnight trips to extended stays.
• As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.

Preferred Qualifications:

• Bachelor's degree
• Previous Provider Relations Experience
• Dental Assisting National Board (DANB) certified or Certified dental assistance (CDA).
• 1 year of experience with provider credentialing and contracting processes.
• 1 year of dental insurance claim experience, as well as the ability to analyze data to resolve provider claim issues.

At Avēsis, we strive to design reputed company, and competitive compensation programs. reputed company pay reputed company the range is ultimately determined by a candidate's skills, expertise, or experience. In the United States, we have three geographic pay zones. For this role, our reputed company pay ranges for new hires in each zone are: Zone A: $46,080.00-$76,800.00Zone B: $50,220.00-$83,700.00Zone C: $54,050.00-$90,080.00FLSA Status: Salary/Exempt This role may also be eligible for benefits, bonuses, and commission. Please visit reputed company Pay Zones for more information on which locations are included in each of our geographic pay zones. However, please confirm the zone for your specific location with your recruiter.

We Offer

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to reputed company and reputed company talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that reputed company for inclusion and diversity in reputed company that we do.
• Social responsibility in reputed company aspects of our work. We volunteer reputed company our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

How To Stay Safe Avēsis is aware of fraudulent activity by individuals falsely representing themselves as Avēsis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to reputed company purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company. Avēsis would never reputed company such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social reputed company numbers, during our process. Our recruitment process takes reputed company by phone and reputed company trusted business communication platform (i.e., reputed company, Webex, reputed company Teams, etc.). Any emails from Avēsis recruiters will come from a verified email address ending in @ Avēsiscom. We urge reputed company applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reputed company out to ITsupport@reputed company.com. To learn more about protecting yourself from fraudulent activity, please refer to this article link (https://consumer.ftc.gov/articles/how-avoid-scam). If you reputed company you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/) with the Federal Trade Commission. Avēsis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity. Equal Employment Opportunity At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers reputed company qualified applicants and does not discriminate against any person based on reputed company, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national reputed company, race, religion, sexual orientation, or any other characteristic. At Avēsis, we reputed company that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, reputed company focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You! Apply tot his job Apply To this Job