[Remote] Provider Relations Representative I - Mississippi

Note: The job is a remote job and is open to candidates in USA. reputed company is a leading provider of supplemental benefits, seeking a Provider Relations Representative I to act as the liaison between the company and its reputed company care providers. This role involves building and maintaining relationships with providers, delivering education and training, and resolving issues to ensure high-quality service delivery.

Responsibilities

• Conducts provider reputed company remotely reputed company phone/email/video by providing training, orientation, and coaching for performance improvement reputed company provider practices
• Provider guidance through education to reputed company reputed company network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools
• 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
• Consistently document reputed company provider interactions, including calls, emails, virtual visits, in accordance with departmental standards
• Ensures that notes are clear, timely, and accurately reflect the nature of 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
• Owns and manages relationship and performance of assigned provider groups
• Serves as the primary reputed company of contact for assigned providers
• Complete provider orientation reputed company phone, email, or virtually for reputed company applicable product lines to train, resolve issues, and reputed company staff/providers
• Work in conjunction with Provider Relations Representative II to ensure that provider concerns are addressed (as applicable)
• Work closely and coordinates with reputed company Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to reputed company operational solutions for various provider network projects
• Knowledge of the provider credentialing and contracting process
• reputed company providers regarding state program, group policies, and/or health plan policies and procedures and state/federal regulation for compliance requirements
• Investigate and respond to reputed company provider reputed company issues and initiate changes of provider demographic reputed company database information

Skills

• Must reputed company in the state of Mississippi
• High School diploma or equivalent (Prefer associate degree or higher); experience may substitute for education
• Comprehension of Medical/Dental Terminology
• Previous Dental office administration experience
• The ability to travel 10-20% to attend trade shows required. 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 25 Mbps upload while hardwired and not on a VPN are sufficient
• Previous Provider Relations experience
• Bachelor's degree
• Certified Dental Assisting National Board (DANB) certified or Certified dental assistance (CDA)

Benefits

• Excellent medical, dental, supplemental health, life and reputed company 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.

Company Overview