Dental Provider Network Management Rep II
Elevance Health

JR128246 Dental Provider Network Management Rep II

Delivers comprehensive support to the dental provider community by thoroughly researching and resolving complex provider issues.

Location: This position will work a hybrid model (remote and office) and must live within 50 miles of one of our Pulse Point office locations in Mendota Heights, MN. and Indianapolis, IN.

Hours: 10:00am - 6:30pm CST

How will you make an impact:

• Responsible for managing and answering incoming calls in a live inbound call queue, providing exceptional customer service by addressing inquiries, resolving issues, and offering support. This role requires the ability to effectively handle extended call durations, ensuring thorough and empathetic communication to meet customer needs and enhance satisfaction.
  
• Serves as point of contact for other internal departments regarding provider issues that may impact provider satisfaction.
  
• Researches and resolves the more complex provider issues and appeals for prompt resolution.
  
• Coordinates prompt claims resolution through direct contact with providers and claims department.
  
• Provides assistance with policy interpretation.
  
• Researches, analyzes and recommends resolution of provider disputes, issues with billing, and other practices.
  
• Assists providers with provider demographic changes as appropriate.
  
• Responds to provider issues related to billing, pricing, policy, systems and reimbursements.
  
• Determines if providers were paid according to contracted terms.
  

• Requires a H.S. diploma or equivalent and a minimum of 3 years of customer service experience; one year experience as a Network Representative; or any combination of education and experience, which would provide an equivalent background.
  

• Prior experience in handling phone calls and providing exceptional customer service is highly preferred.