Pierre, SD, United States
Jun 29, 2020
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 clients with best-in-class product choices and services. Today, our programs cover more than 8.5 million members throughout the country. We strive for excellence in all that we do and our benchmark performance in terms of member satisfaction and client retention underscores this singular focus. 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 while never sacrificing the highest quality of service. Providing outstanding customer service is a top priority, and our core values of accountability, empowerment, excellence, and integrity help us achieve high member and client satisfaction.As of January 2016 Avesis is a wholly-owned, independent subsidiary of The Guardian Life Insurance Company, a distinction that brings even more capabilities to Avesis. The Guardian is a Fortune 250 mutual insurance company that has put its policyholders and clients above all else for more than 150 years, and it has earned them not only a great reputation but awards and accolades from such authorities as J.D. Power. Adhering to high standards, doing the right thing, and making people count are the founding principles that has kept Guardian financially sound and made them one of the largest insurance companies in the country. In January 2017, Premier Access joined the Avesis family. Premier Access has focused on direct state contracts for Medicaid and Chip, specifically in California and Utah. They were one of the original participants in the Chip and Medicaid programs. Description Position Overview: Avesis is a growing national provider of eye care, dental, and hearing services with approximately 8.5 million members. The Dental Provider Relations Field Representative (External) is a 100% remote/telecommuting position which exists in Avesis Provider Relations Department. Candidates must reside in the State of Kentucky, within a 60-mile radius of Paducah/Madionsonville and have the ability to work from home. The Provider Relations Representative is responsible for covering his/her assigned territories while acting as a timely and professional liaison to the Dental provider community. Essential Job Functions: Function as the first point of elevation for provider issue resolution. Manage sophisticated and/or strategic relationships between Avesis and assigned provider groups by responding to provider requests via phone, e-mail and fax. Act as liaison for provider issues including claims questions, termination requests and profile change requests. Educate providers and office staff on insurance plans, fees and administrative plan requirements. Collect, analyze and evaluate reimbursement data. Negotiate fee exceptions. Facilitate and explain the credentialing process. Conduct on-site chart audits and clinical facility reviews of vision provider offices. Represent the organization or the department's perspective at external functions as needed. Complete special projects as assigned. NOTE: Avesis does not intend the description above to be all-inclusive. Selected candidate may perform other related duties as negotiated to meet the ongoing needs of the organization. Position Requirements Requirements Minimum 3-5 years' of dental industry experience. Minimum 3-5 years' experience in customer service or public relations. Knowledge of health plan operations preferred. The minimum education level required is a bachelor's degree; however, experience may substitute for education if responsibilities directly relate to the essential job functions. 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 is a must. Must be able to work a flexible 40 hour week. Ability to travel up to 50%. Must have a valid drivers license Benefits Medical/Dental/Vision 100% paid STD/LTD 100% Paid Life Insurance PTO 401(k) Tuition Reimbursement When applying online, please submit a cover letter with salary requirements along with your resume. Category Provider Management Full-Time/Part-Time Full-Time Exempt/Non-Exempt Exempt EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. This position is currently accepting applications.