TN Provider Relations Representative

Doral Dental is the nation’s leading administrator of Government Dental programs.  We are currently seeking a TN Provider Relations Representative to join our Client Services team. This individual will be responsible for strengthening and expanding the existing provider network. Specific responsiblities include:

 

 

· Increase member access for EPSDT submission by strengthening and expanding the existing provider network.

· Serve as direct contact and resource for market providers.

· Contact participating offices to proactively resolve issues and strengthen relationships.

· Assist provider offices in filing their claims electronically.

· Serve as a liaison between dental offices and Doral Dental by answering remittance, payment, benefit, claims, and eligibility questions when necessary.

· Update Tennessee Executive Director regularly on major issues, both internal and external.

· Provide recommended solutions to Tennessee Executive Director to market issues.

· Increase access for members by strengthening and expanding existing network.

· Monitor provider networks using GEO and work with network development to ensure adequate networks.

· Recruit participating and non-participating providers to higher levels of participation.

· Follow up with missing credentialing and re-credentialing information as assigned.

· Complete all assigned site visits within 21 days.

· Represent clients and Doral at health fairs, audits, dental summits, etc.

· Develop complete understanding of the Office Reference Manuals.

· Develop and continually improve personalized presentations of Doral (present Doral and the TennCare Program via telephone and in person)

· Maintain and submit all required reports.

· Assist in resolving complaints and issues for the TennCare client, members and providers.

· Obtain testimonials/letters of recommendation from providers.

· Participate in the determination and implementation of corrective action plans.

· Perform miscellaneous tasks including, but not limited to, assisting with projects as assigned by the Tennessee Executive Director.

 

Job Requirements:

Candidates for this position must have previous experience in sales, marketing, health care, dental care, or insurance  industry preferred. Knowledge of government programs also preferred.

Other requirements include a Bachelor's Degree, knowledge 0f general computer software(PowerPoint, Excel, and MS Word), excellent verbal and written communications skills, the ability to prioritize and adapt to changing priorities, must be able to multi-task, possess the ability to create and deliver presentations to various sized groups, pay attention to detail, accuracy, and organization skills. Candidates must also be willing to travel and work independently.