Provider Network Management Rep II - Dental

Anticipated End Date:

Position Title:

Provider Network Management Rep II - Dental

Job Description:

Provider Network Management Rep II - Dental

Location:

This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours:

Monday through Friday 10:00am - 6:30pm CST

The Network Management Rep II provides comprehensive services to the provider community through researching more complex provider issues.

How you will make an impact:

* 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:

* Healthcare insurance experience highly preferred.

* Prior experience in handling phone calls in a call-center environment and providing exceptional customer service is highly preferred.

For candidates working in person or virtually in the below location(s), the salary
* range for this specific position is $25.69 to $42.20

Locations:
California, Colorado, Minnesota, Nevada

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.

No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Level:

Non-Management Non-Exempt

Workshift:

1st Shift (United States of America)

Job Family:

PND  Provider Relationship Account Mgmt

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,…