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Long Beach

    Provider Relations Coordinator - Long Beach, United States - Dental Health Services

    Dental Health Services
    Dental Health Services Long Beach, United States

    2 weeks ago

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    Description

    Job Description

    Job Description

    You will contribute to the strength of our team approach to collaborative dental health.

    Do you value making an impact and doing meaningful work? Are you ready to be a difference-maker at an established independent Employee-Owned specialized healthcare company? If you enjoy working with a team of caring and dedicated people, this could be your new home

    Job Summary

    The Professional Service Coordinator is responsible for providing administrative and clerical support to and for the Professional Services team. Maintains professionalism in all communications with other service departments, provider offices, auditors, and vendors. Prepares business correspondence, spreadsheets, provider information and materials and participates in special projects as needed. Is responsible for assisting with provider credentialing, internal office communications, maintaining provider files and updating provider databases and performing other duties as assigned.

    Essential Responsibilities

    • Responsible for supporting contracting and credentialing of newly added contracted dentists and specialists including preparing welcome letters with copies of completed contracts.
    • Supports the process of terminating contracted dentists and specialists, including termination letters, letters to members affected by a change in network, and all necessary data modifications.
    • Maintenance of all dentist and specialist files including paperless and hard files.
    • Responsible for special projects correcting errors identified within the provider source data base.
    • Responsible for quarterly notifications to contracted providers of Accessibility, Satisfaction, SB137; and tracking responses in Aldera system, spreadsheet reporting and notification of reporting results.
    • Track and follow-up on any potential provider or specialist pending contracts.
    • Assist the Professional Services Specialist team including any outreach, notification, or communication to a contracted or potential provider.
    • Must communicate all network changes to the Professional Services Department, interdepartmental liaison including responding to other departments various request.
    • Responsible for the production and maintenance of provider manuals.
    • Perform monthly updates and audits of dental networks.
    • Resolves Aldera software issues when requested and required
    • Maintains monthly Capitation and Roster list including assisting contracted providers with CAP Remittance advice
    • Assists with DMHC, OIC, OID audits.
    • Performs any and all additional duties as requested and directed for this position.

    Basic Qualifications

    Experience

    • Minimum of 1-3 years of related experience in a dental service support role

    Education

    • High school diploma or equivalent
    • Some college preferred

    License, Certification, Registration

    • N/A

    Additional Requirements

    • Working knowledge of provider service operations in a dental plan member/provider environment.
    • Knowledge of provider service principles, HIPAA, PHI and other applicable regulations and requirements in a healthcare setting.
    • Strong written and verbal communication skills and problem-solving techniques.
    • Effectively resolving client/provider/TPA/etc. issues, effectively addressing inquiries to the satisfaction of the questioner, elevating issues as appropriate.
    • Efficiently, accurately and completely supporting dental providers.
    • Effectively working with team members across the enterprise to accomplish projects and performance goals.
    • Maintaining a high level of integrity and appropriate confidentiality in all activities and efforts.

    Position Details

    • Primary Location: Long Beach, California
    • Job Schedule: Full time
    • Scheduled Weekly Hours: 40
    • Shift: Monday – Friday; 8:00 am to 5:00 pm
    • Travel: No

    We look forward to having you on our team

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