Provider Relations Representative

Aston Carter•Lincoln, NE

3d•$19 - $19•Remote

About The Position

The Provider Relations Representative supports dental providers and members by handling data entry, processing, and customer service activities related to provider participation, credentialing, contracts, and billing concerns. This fully remote role (after initial in-office training in Lincoln, NE) requires a highly motivated, detail-oriented professional who can multitask across multiple systems, manage a steady volume of calls and emails, and engage in clear, sometimes difficult billing-related conversations while maintaining a high level of accuracy and professionalism.

Requirements

High school diploma or GED is required.
Ability to handle approximately 20 calls per day while managing email correspondence and billing-related concerns.
Strong data entry skills with a high level of accuracy and attention to detail.
Customer support experience or aptitude, with the ability to communicate clearly and professionally via phone, email, and voicemail.
Demonstrated ability to multitask effectively across multiple software systems and queues.
Comfort having tough conversations, particularly related to billing issues, while maintaining professionalism.
Accountability for meeting daily processing numbers, functional metrics, and audit requirements.
Adaptability to change, including new systems, processes, and policies.
Proficiency with multiple software programs, including a current DOS-like system and the ability to learn a new system.
Ability to work independently in a remote environment without close supervision or extensive hand-holding.
Strong organizational skills and the ability to manage queue-based work such as provider adds, terminations, and fee schedule updates.
Willingness to learn and be trained on job duties, systems, and procedures, regardless of prior industry experience.

Nice To Haves

Associate’s degree or equivalent education is preferred.
2–4 years of related experience is preferred, but the role is also open to new graduates and candidates from diverse professional backgrounds.
Experience in data entry, customer support, or billing systems is beneficial.
Familiarity with multitask software and working across multiple systems simultaneously is an advantage.
Strong attention to detail and accuracy in documentation and audit-related tasks.
Ability to mentor peers and assist in training new hires is a plus.
Interest in professional development, leadership development programs, and ongoing learning opportunities.
Comfort working in a metrics-driven environment with performance measured through scorecards covering turnaround time, accuracy, customer service, and PTO.
Motivation to take advantage of tuition reimbursement and other educational support programs.

Responsibilities

Serve as the primary point of contact for dental providers regarding participation status, credentialing, and contract-related questions.
Process new provider applications, credentialing requests, and updates or changes to provider records with accuracy and timeliness.
Respond to provider and member inquiries via phone, email, and voicemail, ensuring professional, courteous, and accurate communication.
Handle approximately 20 calls per day while managing email correspondence and billing-related concerns.
Manage queue-based tasks, including provider additions, terminations, fee schedule updates, and contract maintenance activities.
Review and submit audits, ensuring all documentation meets compliance and credentialing standards.
Support assigned provider groups by managing all related communications, requests, and follow-up activities.
Collaborate with internal departments and network leasing partners to ensure data consistency, accurate contract loading, and seamless provider experiences.
Investigate and help resolve complaints from providers and members, coordinating with Compliance and other internal teams when necessary.
Participate in tough conversations related to billing issues while maintaining professionalism and clear communication.
Mentor peers and assist with training new hires on systems, processes, and procedures as needed.
Attend team meetings and remain current on internal processes, policies, and industry regulations.
Meet or exceed daily processing numbers, functional metrics, and audit standards as measured through personalized scorecards.
Maintain strong attention to detail while working in multiple software systems simultaneously.
Adapt to system and process changes, including transitioning from a current DOS-like system to a future new system.