Provider Relations Representative II, Dental - Mississippi

Avesis

1d • $46,080 - $90,080 • Hybrid

About The Position

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. At Avesis, the Provider Relations Representative plays a vital role in connecting our dental provider community with the resources, education, and support they need to thrive. As a key member of our Provider Relations Department, you’ll be the bridge between Avesis and our participating provider network, ensuring that our partners are equipped, informed, and engaged every step 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 Avesis’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 lead 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 within 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 Avesis provider experience including direct provider engagement and training with the goal of resolution of issues.

Requirements

• High School Diploma or equivalent.
• 1 to 2+ years of Dental office experience.
• Comprehension of Medical/Dental Terminology.
• Must reside within the state of Mississippi
• A valid driver's license with proof 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.

Nice To Haves

• 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.

Responsibilities

• Conduct provider outreach via in-person/video/phone or email by providing training, orientation, and coaching for performance improvement within provider practices.
• Provide 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.
• Consistently documents all 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 point 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 via phone, email, in-person and/or virtually for all applicable product lines to train, resolve issues, and educate staff/providers.
• Perform onsite facility reviews, when applicable and conduct quarterly face-to-face visits within the assigned territory and/or market.
• 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.
• 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 complex provider related issues and initiate change of provider demographic related database information.
• Responds to general provider contract inquiries, provider education and non-routine claim issues.
• Attend work-related events/conferences while representing the organization and brand in a professional manner.
• Coaches, mentors, and develops junior team members as applicable.

Benefits

• 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.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED