Dental Network Service Representative - Remote Eligible

Job Opportunity At United Concordia Dental

This job services United Concordia Dental's (UCD's) clients by recruiting, training and servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract development/renewal and financial reimbursement. Meet with dentists and office personnel to act as the intermediary between the organization and UCD. Respond to contractual and payment issues both internally and externally. Ensure compliance with contractual terms through regular on-site audits. Apply an active role in network management, training, monitoring and enforcement of company policies and procedures while increasing provider efficiencies.

Essential Responsibilities:

• Identify and initiate contact with prospective providers. Develop and follow up on leads in an established time frame, while incorporating a sound business plan strategy to support and execute recruitment efforts that include existing and prospective client needs and provider resignations/terminations.
• Analyze and develop network retention strategies for follow up services to providers by establishing and maintaining contact and rapport with dental staff members, office managers, insurance coordinators, hygienists and dentists throughout an assigned territory by scheduling face-to-face meetings with dental offices.
• Perform effective on-site visits through educating providers on the financial advantages and marketing incentives of participation. Train dental office staff on the use of automated services to ensure they utilize various means of automated communication, as well as, claims and electronic data interchange and electronic funds transfer.
• Act as subject matter expert with recommendations and data supporting development of network and sales strategy and support of leasing contract negotiation. Develop and maintain leasing revenue targets. Update network lease risk strategy in response to all market changes.
• Develop and manage process improvement initiatives designed to maintain URAC accreditation of all network practices associated with government programs using continuous quality improvement principles. Conduct, collect and analyze data from office site visits and reviews to continually improve the care and service to members and provide recommendations to internal customer supporting quality improvement programs.

Education:

• Required: High School Diploma/GED
• Preferred: Bachelor's Degree - Business

Experience:

• Required: 3 - 5 years of experience in the healthcare/insurance industry or professional experience in presenting concepts and influencing others in varying audiences
• Preferred: 3-5 years of experience as Dental Office Manager or Dental Hygienist

Skills:

• Written and oral communication skills
• Time management and organizational skills
• Knowledge of ADA/CDT codes and general dental terminology
• Negotiation skills
• Ability to analyze situations, determine points of relevance and proper course of actions

Physical, Mental Demands and Working Conditions:

• Position Type: Office-Based
• Teaches / trains others regularly: Does Not Apply
• Travel regularly from the office to various work sites or from site-to-site: Occasionally
• Works primarily out-of-the office selling products/services (sales employees): Never
• Physical work site required: Yes
• Lifting: up to 10 pounds Constantly: Lifting: 10 to 25 pounds Occasionally: Lifting: 25 to 50 pounds

Pay Range Minimum: $50,200.00 Pay Range Maximum: $91,200.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.