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Title

Dental Provider Service Representative 

About the Organization Avesis has been providing essential ancillary benefit solutions since 1978. Since its inception Avesis has developed, administered and refined its offerings to provide client groups with best-in-class product choices and services. Today, our programs cover more than seven million members throughout the country. We strive for excellence in all that we do and our benchmark performance in terms of patient satisfaction and client retention underscores this singular focus.

Our vision, dental and hearing benefit programs are designed to reduce sponsor and participant costs by delivering services through customized provider networks, tailoring them to best address the special needs of our clients and their covered members. All network providers are stringently credentialed in accordance with NCQA standards. Participating audiologists, dentists, optometrists, ophthalmologists, and opticians have agreed to accept significantly reduced fees for their services and products. These reduced fees are passed on to sponsors and participants by way of our comprehensive plan offerings.

The continued upward spiral in health care costs has challenged sponsors, providers and payers of health benefits to deliver high quality care in the most cost-effective manner possible. The Avesis benefits menu has been created to meet that challenge by making available quality essential ancillary benefit services at the lowest possible price.

EEO Statement: Avesis, Incorporated is an equal opportunity employer. All qualified applicants will receive consideration for emplyoment without regard to race, color, religionk, gender, sexual orientation, gender identity or expression, national origin age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable law.
 
Description

Position Overview:

NOTE: THIS POSITION IS LOCATED IN CENTRAL ILLINOIS

Avesis is a growing national provider of vision, dental, and hearing services with over 6 million members. Avesis is currently hiring a Dental Provider Service Representative to work remotely in central  Illinois. You will act as liaison between Avesis and the dental provider community. The candidate is responsible for timely and professional interaction with dental providers, visiting the dental providers and their dental staff in the dental office environment. Representative will need to provide training to dental teams.

Duties and Responsibilities:

  • Manage the relationship between Avesis and the dental provider network
  • Works cross-functionally with Provider Relations staff, Outreach and Education staff, Quality Assurance staff, the IT staff and the State Dental Director to ensure superior execution of the Medicaid Dental program
  • Serve as the Avesis primary point of contact for Health Plan
  • Facilitates recurring program status meetings and provides updates and reporting on dental program delivery and operations to all stakeholders
  • Identifies issues that may impact performance and creates recommendations for resolution
  • Works with State Dental Director to plan and deliver dental Provider education sessions designed to increase knowledge of special care needs for young children, pregnant women and other special needs populations
  • Recognizes and adjusts to diverse social and cultural backgrounds of the population being serviced
  • Respond to provider inquiries to assist providers with any service issues that arise, as well as escalating issues, both recurring and critical, to appropriate individual(s). Issue resolution may include but is not limited to the areas of eligibility, claims, credentialing, and member benefit programs
  • Administers office/chart audits
  • Utilization management tasks

Will need to travel to locations not accessible by public transportation

 
Position Requirements

Requirements

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• Bachelor's degree or significant work experience in the healthcare field

• 2+ years of experience with direct dental provider communication

• Successful record of managing relationships, and leading others

• Direct experience with Dental Medicaid or managed care plans

• Excellent interpersonal skills, ability to work cross-functionally with various levels of staff

• Excellent verbal and written communication skill

• Strong presentation and organizational skills

• Excellent computer skills in a Microsoft Windows environment

NOTE: CANDIDATE MUST HAVE 2 YEARS OF DENTAL EXPERIENCE

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Benefits

  • Medical/Dental/Vision
  • 100% paid STD/LTD
  • 100% Paid Life Insurance
  • Vacation/Sick/Personal/Holiday
  • 401K

Please submit a cover letter with salary requirements along with your resume

 
Category Dental Utilization  
Full-Time/Part-Time Full-Time  
Exempt/Non-Exempt Non-Exempt  
EOE Statement We are an Equal Opportunity Employer.  

This position is currently not accepting applications.

To search for an open position, please go to http://absolutecarehealth.appone.com



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