Provider Relations Representative

3 weeks ago


Reston, Virginia, United States The Nagler Group Full time

Job Title: Provider Relations Representative

Job Summary:

We are seeking a highly skilled Provider Relations Representative to join our team at The Nagler Group. As a key member of our team, you will be responsible for delivering exceptional client service to doctors, doctor's office staff, members, and plan sponsor representatives.

Key Responsibilities:

  • Respond to inbound telephone calls, faxes, and emails from doctors, doctor's office staff, and plan sponsor representatives in a timely and professional manner;
  • Process dental claims on our system for all clients;
  • Process claim corrections from daily EDI reports;
  • Document communications with doctors and doctor's office staff, and plan sponsor/employer representatives;
  • Respond to claim inquiries from subscribers, doctors, and plan sponsor/employer representatives in a timely and professional manner;
  • Maintain knowledge of dental plan designs, exclusions, limitations, and exceptions for each client;
  • Adhere to all process and procedural guidelines;
  • Any other duties as assigned.

Requirements:

  • Dental experience, X-ray knowledge, and/or dental coding knowledge;
  • Excellent communication and customer service skills;
  • Ability to work in a fast-paced environment and meet productivity expectations;
  • Strong analytical and problem-solving skills;
  • Proficiency in dental plan designs, exclusions, limitations, and exceptions.

What We Offer:

Competitive salary and benefits package; opportunities for professional growth and development; and a dynamic work environment.



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