JR128248 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., 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.

Minimum requirements:

• 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.

Preferred Skills, Capabilities, and Experiences:

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

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.