Dental Provider Relations Field Representative - (California)
Full Time
Remote
Posted
Job description
Join us for an exciting career with the leading provider of supplemental benefits!
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
As a Provider Relations Representative, you will develop and execute the key components to drive initiatives for overall department strategies to service and manage our provider networks with a heavy influence on fostering and maintaining relationships with network providers. The Provider Relations Representative will collaborate activities with an innovative thought leader approach on collaboration with all departments that will result in an exceptional provider experience that is supported by outstanding education, customer service, and issue resolution.
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
You have
- Bachelor's degree preferred. Experience may substitute for education if responsibilities directly relate to the essential job functions.
- Minimum 3 years of dental industry experience
- California Medicaid, Commercial DHMO, PPO insurance knowledge preferred
- Knowledge of health plan operations required.
- Strong skills in using Microsoft Office applications and other windows-based applications
- Self-starter with the ability to work independently and as a part of a team
- Strong research, problem solving and organizational skills
- Ability to communicate well with providers and office staff both verbally and in writing
- Ability to multi-task and work in a fast-paced environment
- Excellent time management skills
- Proficient in Microsoft Office Suite, specifically Word and Excel
- Strong presentation skills
- Basic knowledge of dental terminology, procedures, and coding preferred
- Passion to be a top performer
- Must be able to work a flexible 40-hour week
- Must have a valid Driver’s License
Candidates must live in Los Angeles, CA or surrounding metro area.
You will
- Improve the Avesis provider experience including direct provider engagement and training, office visits and network adequacy monitoring
- Conduct provider outreach by providing training and guidance to enable Access Dental Plan network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools
- Manage sophisticated and/or strategic relationships between Access Dental Plan and assigned provider groups by responding to provider requests via phone, e-mail, and fax.
- Educate providers and office staff on insurance plans, fees, and administrative plan requirements
- Negotiate fee exceptions
- Working knowledge of credentialing process
- Conduct on-site facility reviews of dental provider offices.
- Monitor specific network utilization and benchmarks for California Medicaid network
- Conduct on-site corrective action plans for offices not meeting contractual requirements
- Knowledge of and ability to use various computer programs such as Microsoft Office including spreadsheet, word processing and presentation software and programs
- Ability to prioritize and organize a diverse workload required
- Excellent verbal and written communication and effective listening skills required
- Other duties as assigned
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 develop and empower 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 advocate for inclusion and diversity in all that we do.
- Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.
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 all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all 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!
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