Denver Provider Partner Consultant, DentaQuest

Job Description

The opportunity:

• Analyze and monitor provider cost reports on an ongoing basis.
• Maintain network participation by supporting dentists and dental office managers.
• Educate providers through office visits and communication.
• Promote technology solutions and increase the volume of electronic claims.
• Negotiate special deals to maintain compliance and increase access.
• Seek continuous improvements by recommending changes in internal methods and procedures.
• Facilitate Oral Health presentations.
• Assist provider offices with filing claims electronically.
• Answer remittance, payment, benefit, claims, and eligibility questions.
• Follow up with all termination letters.
• Represent clients and company at trade shows, health fairs, audits, dental summits, etc.
• Maintain and submit all required reports.
• Resolve elevated complaints and issues for clients, members, and providers.
• Obtain letters of recommendation from providers.
• Develop personalized presentations of company benefit programs.
• Recruit participating and non-participating providers to higher levels of participation.
• Manage CAP office performance.
• Develop and implement approaches to improve the quality of information exchanged between the company and dental offices.
• Resolve difficult claims issues.
• Increase access for members by strengthening and expanding existing networks.

Qualifications

• Bachelor’s Degree in Business, Healthcare Administration or related field (or relevant work experience)
• 3 years’ related work experience in healthcare environment
• Strong presentation skills
• Excellent verbal and written communication skills
• Ability to work independently and as part of a team
• Knowledge of Microsoft Office
• Proven problem-solving skills
• Up to 50% local travel required
• Problem solving and training experience
• Ability to make good judgments based on data available with minimal supervision

Benefits

• Comprehensive benefits package including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company-paid life and AD&D insurance, disability programs, and a partially paid sabbatical program.
• Retirement plans such as a 401(k) employer match, stock purchase options, and an employer-funded retirement account.
• A flexible, inclusive, and collaborative work environment that supports career growth.

Pay

Salary Range: $63,000 - $94,500

Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business.