Provider Experience Agent

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 38 days.
• No salary listed.

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NationsBenefits

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2013

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Private Equity Round on 2022-04

Healthcare • Consulting • Logistics

NationsBenefits is a leading healthcare technology company that specializes in providing financial technology solutions and supplemental benefits management. The company offers a variety of services, including hearing care through NationsHearing, health and wellness products via NationsOTC, and meal delivery through NationsMarket. NationsBenefits also provides specialized services like emergency assistance, healthcare transportation, and personalized health guidance using artificial intelligence. Their proprietary platforms, including Benefits Pro™, facilitate member support, benefit configuration, and e-commerce transactions. NationsBenefits focuses on improving member outcomes, closing care gaps, and enhancing satisfaction through advanced analytics and custom programs.

📋 Description

• Serve as the primary point of contact for dental providers and network partners • Resolve escalated issues related to claims, credentialing, authorizations, payments, and plan-specific benefit questions • Act as the bridge between providers and internal operations, claims, and client services teams • Own escalated provider issues from intake through resolution, including tracking, follow-up, and root cause documentation • Respond to provider inquiries on claims, eligibility, benefits, fee schedules, and payment disputes within defined turnaround standards • Coordinate with claims, credentialing, contracting, and client services teams to resolve cross-functional issues • Support leased network partners and direct-contracted providers, including onboarding and orientation to NationsDental processes • Identify trends in provider complaints and recommend process or training fixes • Maintain an escalation log and report on volume, categories, aging, and resolution times • Educate provider offices on plan-specific benefits, authorization requirements, and billing guidelines • Support compliance requirements, including provider complaint handling, directory accuracy, and health plan client oversight requests • Participate in provider outreach, webinars, and office visits as needed • Measure success through escalation resolution, provider satisfaction, reduction in repeat issues, and accurate escalation documentation

🎯 Requirements

• High school diploma or equivalent required • Associate degree or higher in business administration, healthcare administration, or a related field preferred • 1 to 3 years in provider relations, provider services, or dental or health plan operations • Working knowledge of dental claims, CDT codes, and provider contracting concepts • Familiarity with Medicare Advantage or Medicaid managed care requirements preferred • Strong written and verbal communication, with the ability to de-escalate frustrated providers • Comfort managing multiple open issues and following up until they are closed • Proficiency with CRM or ticketing tools and Excel • Experience working with DSOs, group practices, or specialty provider organizations preferred • Comfort presenting to provider offices and practice leadership in webinars and office visits

🏖️ Benefits

• Career advancement opportunities from within the organization • Fulfilling work environment • Opportunity to contribute to innovative healthcare solutions • Opportunity to help shape the future of ancillary healthcare benefits • Opportunity to improve access to quality dental care for millions of members

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