Dental Chart Reviewer Representative

Join us for an exciting career with the leading provider of supplemental benefits! Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. Position Summary Avēsis is a growing national provider of eye care, dental, and hearing services with approximately 8.5 million members. The Dental Chart Review Representative position is a 100% remote/telecommuting position which exist as part of the Provider Relations Department and have the ability to work from home. The Dental Chart Representative will be responsible for chart audit reviews covering his/her assigned territories while acting as a timely and professional review liaison to the dental provider community. This position would work closely and collaborate with the Clinical Management team along with other internal units/stakeholders/SMEs within Avesis organization. You have

• Minimum 3 years of dental industry experience and clinical knowledge.
• Minimum 3 years of experience in customer service or provider relations.
• Knowledge of health plan operations preferred.
• The minimum education level required is a bachelor's degree; however, experience may substitute for education if responsibilities directly relate to the essential job functions.
• Self-starter with the ability to work independently and as a part of a team.
• Strong research, problem solving and organizational skills.
• Ability to communicate well with providers and office staff both verbally and in writing.
• Ability to multi-task and work in a fast-paced environment.
• Excellent time management skills.
• Proficient in Microsoft Office Suite, specifically Word and Excel.
• Strong presentation skills.
• Basic knowledge of dental terminology, procedures, and coding preferred.
• Passion to be a top-performer is a must.
• Must be able to work a flexible 40-hour week.
• Ability to travel as needed.

You will

• Conduct chart audit reviews and work s and clinical facility reviews remotely of dental provider offices.
• Manage sophisticated and/or strategic relationships between Avesis and assigned provider groups by responding to provider requests via phone, e-mail, and fax.
• Act as liaison for provider issues including claims questions, termination requests and profile change.
• Educate providers and office staff on insurance plans, fees, and administrative plan requirements.
• Collect, analyze, and evaluate reimbursement data.
• Negotiate fee exceptions.
• Facilitate and explain the credentialing process.
• Conduct on-site chart audits and clinical facility reviews of dental provider offices.
• Represent the organization or the department's perspective at extern al functions as needed.
• Complete special projects as assigned.

We Offer

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision 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.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

Equal Employment Opportunity At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You!