Dental Network Service Coordinator

6 days ago

Plano, United States Zelis Healthcare Full time

Position Overview

The Zelis Dental Network Service Coordinator has daily interaction with internal departments as well as external conversations with the Provider Network as needed. This position requires the adaptable knowledge of all elements of Zelis Network processes and policies to enable and promote completion of projects, tasks and or assignments. Sound and objective decision making must be exercised in all interactions within Network Development and Network Operations and other internal departments. A position that demands accuracy, focus, critical thinking and application and careful documentation.

If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative, and supportive environment - while still being valued for your individual strengths - Zelis Dental Network is the place for you.

Summary of Responsibilities

  • Servicing email requests from providers, including responses conveying messaging that is scripted and non-scripted to resolve provider inquiries
    • Executes and manages owned responsibilities and tasks through categorized incoming email
    • Highly motivated production with outcome-driven results for optimal provider satisfaction as a stakeholder in the department revenue goal
    • Accountable for the Network validity and accuracy for optimal re-pricing opportunities
  • Integrates knowledge from PLU and Credentialing Database to synergize complex data to create and communicate work-orders for the data team to assure data accuracy for re-pricing capabilities and online directories
    • Completes all required documentation accurately, in a timely manner, and thoroughness in accordance with department standards
    • Assigns and shares Fee Schedules
    • Verifying and updating provider demographics and files for Zelis Clients and Providers
    • Oversight of active providers to additional locations
    • Terminate providers, following clearly documented termination guidelines
  • Requesting and obtaining information from providers which will include but not limited to assist and resolve provider issues/concerns/complaints
  • Share results and issues to management
  • Administrative and Provider Relations experience
  • Prepare Contracts to present for Credentialing, for accurate provider data management and entry into operational systems
  • Collaborating with the Credentialing Team to assist in application completion.
  • Prepare monthly Delegated and Client Validation reports that are shared to the Data Team
  • Collaborate and assist Network Recruiters
  • Special team projects as needed and assigned by management

Summary of Qualifications

  • A strong aptitude for listening and problem solving
  • Dependable, resourceful, self-motivated team player
  • Strong time management skills with the ability to change priorities quickly as needed
  • Strong organizational skills with an ability to handle multiple priorities
  • Ability to make administrative/procedural decisions and judgments
  • Ability to investigate and analyze information and draw conclusions
  • Maintain confidentiality of Zelis Assets

Education / Experience

  • High School Diploma/GED
  • At least two (2) years' experience in a customer focused position
  • Advanced level knowledge and proficiency of MS Office, including Excel, Word, Outlook, PowerPoint etc. and related applications

Location and Workplace Flexibility

We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We're Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity,Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you're contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

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