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Key Responsibilities:
- Own escalated provider issues from intake through resolution, including tracking, follow-up, and root cause documentation.
- Respond to provider inquiries on claims, eligibility, benefits, fee schedules, and payment disputes within defined turnaround standards.
- Support compliance requirements, including provider complaint handling, directory accuracy, and health plan client oversight requests.
Requirements:
- High school diploma or equivalent required; associate degree or higher in business administration or healthcare administration preferred.
- 1 to 3 years in provider relations, provider services, or dental or health plan operations.
- Working knowledge of dental claims, CDT codes, and provider contracting concepts.
Why Join NationsBenefits?
- Be part of an organization experiencing rapid growth and innovation within the Medicare Advantage industry.
- Strengthen provider relationships, resolve issues at the root, and help shape the future of ancillary healthcare benefits.
- Opportunity to improve access to quality dental care for millions of members.
NationsBenefits
NationsBenefits is a Healthcare Fintech provider of supplemental benefits, flex cards, and member engagement solutions that partners with managed care organizations. It is recognized as one of the fastest-growing companies in America with career advancement opportunities across multiple locations in the US, South America, and India.