Provider Relations Representative I - Mississippi

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. At Avesis, the Provider Relations Representative I plays a pivotal role within the company, acting as the essential liaison between the company and its network of participating vision care providers. As a member of the Provider Relations Department, the Provider Relations Representative is responsible for building and maintaining strong, positive relationships with providers to ensure seamless collaboration and high‑quality service delivery. As the face of Avesis to the provider community, the PR1 ensures that both Avesis and its network of providers operate in sync to deliver exceptional vision care to members. This is a fantastic opportunity to make a meaningful impact, work with diverse healthcare professionals, and contribute to the growth and success of a thriving organization. If you’re passionate about relationship‑building, problem‑solving, and driving excellence in healthcare, this role is for you. Responsibilities In this dynamic role, you will deliver best‑in‑class provider education and training, ensuring providers are well‑informed on processes, policies, and new initiatives. You will also act as a problem‑solver, working to resolve provider issues, research and address challenges, and lead key projects that enhance provider engagement and satisfaction. Functional Competencies Direct provider engagement and training to improve the Avesis provider experience. Conduct provider outreach remotely via phone/email/video, providing training, orientation, and coaching for performance improvement. Conduct monthly and/or quarterly meetings with provider groups, documenting discussions, issues, attendees, action items, and researching claims or prior authorization issues. Consistently document all provider interactions in accordance with departmental standards. Maintain thorough and timely records to ensure accountability, transparency, and effective information sharing. Own and manage relationship and performance of assigned provider groups, serving as the primary point of contact. Complete provider orientation via phone, email, or virtual for all applicable product lines. Work with Provider Relations Representative II to ensure provider concerns are addressed. Coordinate with Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, Account Management, and other staff to develop operational solutions for provider network projects. Knowledge of the provider credentialing and contracting process. Educate providers regarding state program, group policies, and health plan policies and procedures, and state/federal regulation for compliance requirements. Investigate and respond to all provider‑related issues and initiate changes to provider demographic data. Intermediate ability to use Microsoft Office applications, spreadsheets, databases, and related systems. Core Competencies Knowledge of dental health plan operations preferred. Knowledge of dental provider/health plan contracts/agreements highly desired. Intermediate proficiency in Microsoft Excel and database applications. Behavioral Competencies Collegiality: building strong relationships company‑wide and mentoring. Initiative: readiness to lead or take action to achieve goals. Communicative: ability to relay issues, concepts, and ideas orally and in writing. Member‑focused: going above and beyond to make members feel valued. Detail‑oriented and thorough: managing and completing assignment details with minimal oversight. Flexible and responsive: managing new demands, changes, and situations. Critical thinking: troubleshoot complex issues, problem‑solve and multi‑task. Integrity & responsibility: ownership of actions and confidentiality. Collaborative: representing own interests while being fair to others in search of workable solutions. Minimum Qualifications Must reside in the state of Mississippi. High school diploma or equivalent (associate degree or higher preferred; experience may substitute). Comprehension of medical/dental terminology. Previous dental office administration experience. Ability to travel 10‑20%; travel times may vary. Remote role: must maintain internet service—50 Mbps download and 25 Mbps upload while hardwired. Preferred Qualifications Previous Provider Relations experience. Bachelor’s degree. DANB certified or CDA. Equal Employment Opportunity At Avesis, 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, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. #J-18808-Ljbffr