Avēsis
Provider Relations Representative II, Dental - Kentucky
Avēsis, Pleasant Home, Kentucky, United States
Overview
Provider Relations Representative II, Dental - Kentucky. Join to apply for the Provider Relations Representative II, Dental - Kentucky role at Avēsis. Join us for an exciting career with the leading provider of supplemental benefits. Our promise is to build communities and grow your career through skill-building, leadership development and philanthropic opportunities, while surrounded by diverse colleagues with high ethical standards. At Avēsis, 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 Avēsis 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 contribute to Avēsis’ mission of delivering high-quality, accessible dental care to our members, while supporting and nurturing the growth of our provider community. Join us in making a meaningful impact in the healthcare space! You will work in a hybrid environment, with the opportunity to build lasting partnerships both remotely and in the field. You will lead efforts to foster best-in-class provider education, tackle provider inquiries and issues, and manage initiatives that enhance our relationships with the provider network. Our chosen candidate must reside within the state of Kentucky due to the travel component of this role.
Responsibilities
Provider Relations encompasses several diverse provider administrative duties to improve the Avēsis provider experience including direct provider engagement and training with the goal of resolution of issues. 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 Avēsis 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. Ensure notes are clear, timely, and accurately reflect the communication to support ongoing relationship management, issue resolution, and continuity of service across teams. Maintain 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. Own and manage relationship and performance of assigned provider groups. Serve as the primary point of contact for assigned providers. Share 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 with Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for provider network projects. Educate providers regarding state programs, 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. Respond 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. Core Competencies
Knowledge of health plan operations. Knowledge of provider/health plan contracts/agreements. Microsoft applications and other Windows-based applications with intermediate Excel skills and data analysis tools. Behavioral Competencies
Collegiality: building strong relationships and supporting team growth. Initiative: readiness to lead or take action to achieve goals. Communicative: ability to relay issues and ideas clearly in writing and orally. Member-focused: ensuring members feel seen, valued, and appreciated. Detail-oriented and thorough: managing details with appropriate oversight. Flexible and responsive: adapting to new demands and changes. Critical Thinking: troubleshoot complex issues and multi-task effectively. Integrity & responsibility: maintain confidentiality when required. Collaborative: represent interests while seeking workable solutions for all parties. Minimum Qualifications
High School Diploma or equivalent. 1 to 2+ years of Dental office experience. Comprehension of Medical/Dental Terminology. Must reside within the state of Kentucky. A valid driver's license with proof of auto insurance and the ability to use your own vehicle. Travel up to 50% 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 remote, maintain internet service capable of completing essential duties; 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient. Preferred Qualifications
Bachelor’s degree Previous Provider Relations Experience Dental Assisting National Board (DANB) certified or Certified dental assistant (CDA). 1 year of experience with provider credentialing and contracting processes. 1 year of dental insurance claim experience and ability to analyze data to resolve provider claim issues. Skills
At Avēsis, we strive to design equitable and competitive compensation programs. Base pay within the range is determined by a candidate’s skills, expertise, or experience. For this role, pay zones and ranges are: Zone A: $46,080.00-$76,800.00 Zone B: $50,220.00-$83,700.00 Zone C: $54,050.00-$90,080.00 FLSA Status: Salary/Exempt This role may also be eligible for benefits, bonuses, and commission. We Offer
Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way. Competitive compensation package. 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. Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent. Flexible time off, dress code, and work location policies to balance your work and life. Employee Resource Groups that advocate for inclusion and diversity. Social responsibility initiatives in sustainability and community involvement. Safety and Equal Opportunity
Avēsis is aware of fraudulent activity by individuals falsely representing themselves as Avēsis recruiters. We would never request purchases, W-2 forms, or personal information during our process. Communications originate from verified Avēsis channels. If something seems off, contact ITsupport@Avesis.com. For fraud protection resources, visit the FTC links provided. Avēsis is an Equal Employment Opportunity employer and values diversity and inclusion. We do not discriminate based on ancestry, age, citizenship, color, creed, disability, gender, gender identity, marital status, military status, national origin, race, religion, sexual orientation, or any other characteristic. Apply and Alerts
Referrals increase your chances of interviewing at Avēsis. Sign in to set job alerts for “Provider Relations Representative” roles.
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Provider Relations Representative II, Dental - Kentucky. Join to apply for the Provider Relations Representative II, Dental - Kentucky role at Avēsis. Join us for an exciting career with the leading provider of supplemental benefits. Our promise is to build communities and grow your career through skill-building, leadership development and philanthropic opportunities, while surrounded by diverse colleagues with high ethical standards. At Avēsis, 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 Avēsis 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 contribute to Avēsis’ mission of delivering high-quality, accessible dental care to our members, while supporting and nurturing the growth of our provider community. Join us in making a meaningful impact in the healthcare space! You will work in a hybrid environment, with the opportunity to build lasting partnerships both remotely and in the field. You will lead efforts to foster best-in-class provider education, tackle provider inquiries and issues, and manage initiatives that enhance our relationships with the provider network. Our chosen candidate must reside within the state of Kentucky due to the travel component of this role.
Responsibilities
Provider Relations encompasses several diverse provider administrative duties to improve the Avēsis provider experience including direct provider engagement and training with the goal of resolution of issues. 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 Avēsis 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. Ensure notes are clear, timely, and accurately reflect the communication to support ongoing relationship management, issue resolution, and continuity of service across teams. Maintain 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. Own and manage relationship and performance of assigned provider groups. Serve as the primary point of contact for assigned providers. Share 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 with Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for provider network projects. Educate providers regarding state programs, 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. Respond 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. Core Competencies
Knowledge of health plan operations. Knowledge of provider/health plan contracts/agreements. Microsoft applications and other Windows-based applications with intermediate Excel skills and data analysis tools. Behavioral Competencies
Collegiality: building strong relationships and supporting team growth. Initiative: readiness to lead or take action to achieve goals. Communicative: ability to relay issues and ideas clearly in writing and orally. Member-focused: ensuring members feel seen, valued, and appreciated. Detail-oriented and thorough: managing details with appropriate oversight. Flexible and responsive: adapting to new demands and changes. Critical Thinking: troubleshoot complex issues and multi-task effectively. Integrity & responsibility: maintain confidentiality when required. Collaborative: represent interests while seeking workable solutions for all parties. Minimum Qualifications
High School Diploma or equivalent. 1 to 2+ years of Dental office experience. Comprehension of Medical/Dental Terminology. Must reside within the state of Kentucky. A valid driver's license with proof of auto insurance and the ability to use your own vehicle. Travel up to 50% 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 remote, maintain internet service capable of completing essential duties; 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient. Preferred Qualifications
Bachelor’s degree Previous Provider Relations Experience Dental Assisting National Board (DANB) certified or Certified dental assistant (CDA). 1 year of experience with provider credentialing and contracting processes. 1 year of dental insurance claim experience and ability to analyze data to resolve provider claim issues. Skills
At Avēsis, we strive to design equitable and competitive compensation programs. Base pay within the range is determined by a candidate’s skills, expertise, or experience. For this role, pay zones and ranges are: Zone A: $46,080.00-$76,800.00 Zone B: $50,220.00-$83,700.00 Zone C: $54,050.00-$90,080.00 FLSA Status: Salary/Exempt This role may also be eligible for benefits, bonuses, and commission. We Offer
Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way. Competitive compensation package. 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. Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent. Flexible time off, dress code, and work location policies to balance your work and life. Employee Resource Groups that advocate for inclusion and diversity. Social responsibility initiatives in sustainability and community involvement. Safety and Equal Opportunity
Avēsis is aware of fraudulent activity by individuals falsely representing themselves as Avēsis recruiters. We would never request purchases, W-2 forms, or personal information during our process. Communications originate from verified Avēsis channels. If something seems off, contact ITsupport@Avesis.com. For fraud protection resources, visit the FTC links provided. Avēsis is an Equal Employment Opportunity employer and values diversity and inclusion. We do not discriminate based on ancestry, age, citizenship, color, creed, disability, gender, gender identity, marital status, military status, national origin, race, religion, sexual orientation, or any other characteristic. Apply and Alerts
Referrals increase your chances of interviewing at Avēsis. Sign in to set job alerts for “Provider Relations Representative” roles.
#J-18808-Ljbffr