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Provider Relations Specialist II

4 weeks ago

Lincoln Nebraska, United States Ameritas Full time

Position Description: 

The Provider Relations Specialist II serves as a liaison between the company and internal and external partners. This position develops and strengthens customer relationships by providing timely and accurate response to inquiries and conducting analysis to solve problems under limited supervision. This position may provide guidance, coaching, and training to associates.

At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services.

 Position Location:

  • This position is remote and does not require regular in-office presence.

 

What you do:

  • Provide quality customer service through daily contact with providers ensuring they are educated on all contractual issues.
  • Strengthen provider loyalty and ensure required persistency of network is achieved.
  • Maintain contract knowledge of all networks to ensure the information provided to our customers is in accordance with guidelines and state requirements.
  • Daily liaison for panel leasing arrangements including administration, customer complaint resolution, and claim discrepancy situations.
  • Extensive knowledge and proficiency of the Managed Care imaging system.
  • Responsible for the credentialing and re-credentialing of our network providers.
  • Responsible for the reporting of providers to the HealthCare Integrity and Protection Data Bank and related state licensing boards.
  • Assist in recruitment of providers in targeted areas and keep abreast of the current recruitment plan to provide accurate information to our customers.
  • Partner with our Provider Network Representatives to help expand our growing network.
  • Develop and maintain relationships with contacts from assigned files, and make the appropriate updates or changes to our system as needed.
  • Assist in the fee negotiation process between active or potential network providers and our Actuarial department, providing the appropriate information for fee review.
  • Provide effective complaint resolution for our insured members and network providers. This may involve educating dental offices regarding their agreement, and acting as a mediator between dental office and insured persons.
  • Meet all functional measurements when processing work from the Managed Care Imaging queues.
  • Partner with the Compliance and Law departments to ensure that we are following state laws involving PPO contracts and Credentialing requirements.
  • Other duties as assigned.

 

What you bring: 

  • H.S. Diploma or GED required, Associate's Degree preferred.
  • 2-4 years related experience required.
  • Previous experience in a Group provider relations role highly preferred.
  • Ability to develop and interpret provider contracts.

 

What we offer: 

A meaningful mission. Great benefits. A vibrant culture 

Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life.

 

At Ameritas, you’ll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don’t: 

 

Ameritas Benefits

For your money: 

  • 401(k) Retirement Plan with company match and quarterly contribution
  • Tuition Reimbursement and Assistance 
  • Incentive Program Bonuses 
  • Competitive Pay 

For your time: 

  • Flexible Hybrid work
  • Thrive Days - Personal time off
  • Paid time off (PTO)

 

For your health and well-being: 

  • Health Benefits: Medical, Dental, Vision 
  • Health Savings Account (HSA) with employer contribution
  • Well-being programs with financial rewards
  • Employee assistance program (EAP)

 

For your professional growth: 

  • Professional development programs
  • Leadership development programs
  • Employee resource groups
  • StrengthsFinder Program

 

      For your community:

  • Matching donations program
  • Paid volunteer time– 8 hours per month

 

For your family: 

  • Generous paid maternity leave and paternity leave
  • Fertility, surrogacy and adoption assistance
  • Backup child, elder and pet care support
 

 

 

An Equal Opportunity Employer

 

Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we’re committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. 

The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan.

Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for all job postings is one way Ameritas shows our commitment to equitable compensation practices.