Provider Relations Representative

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.

The Provider Relations Representative is tasked as part of the Provider Relations Department, to be the liaison between Avesis and the participating provider network. The Provider Relations Representative will be responsible for coordinating efforts to build and nurture positive relationships with the Avesis eye care/dental/hearing provider community to include but not limited to best in class provider education and training, issues research and projects.

Essential Job Functions: 

• Provider Relations encompasses several diverse provider administrative duties to improve the Avesis provider experience including direct provider engagement and training with the goal of resolution of issues.
• Conducts provider outreach remotely via phone/email/video by providing training, orientation, and coaching for performance improvement within provider practices. Provider guidance through education to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools.
• 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.
• Act in a supportive role for the assigned provider territory (as applicable)
• Work in conjunction with Provider Relations Representative II to ensure that provider concerns are addressed (as applicable)
• Work closely and coordinates with Avesis Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for various provider network projects.
• Knowledge of the provider credentialing and contracting process
• 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 all provider related issues and initiate change of provider demographic related database information.
• Knowledge of and intermediate ability to use various computer programs such as Microsoft Office including spreadsheets, data bases, word processing and presentation software and programs/systems utilized in data analysis.
• Ability to analyze, prioritize and organize a diverse workload required.
• Excellent verbal and written communication and effective listening skills required.
• Other duties as assigned.

Requirements:

• High School diploma or equivalent required. Associate degree or higher preferred; experience may substitute for education
• Previous dental office administration experience
• Knowledge of health plan operations
• Knowledge of provider/health plan contracts/agreements
• Excellent communicator
• Medical/Dental Terminology
• Customer Service and communications oriented.
• Strong skills in using Microsoft Office applications and other windows-based applications to include an intermediate level in Microsoft Excel and databases.

A valid driver's license and the ability to use your own vehicle is required. The ability to travel up to 50% is required to meet prospective clients, existing customers, attend trade shows, and to generate prospective sales leads.  Travel requirements may vary at different times of the year and can range from short/overnight trips to extended stays, visiting different regions to oversee project/client implementation or to provide guidance to our customers.  Modes of transportation may also include public transportation, such as rail, bus, car and/or plane.  Travel/mileage reimbursement will be provided in alignment with the IRS annual mileage program and/or receipts submitted through the company expense report policy.

FLSA Status: Hourly / Non-Exempt

Salary Range: $16.68 – $26.07

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!

Apply