Provider Relations Representative (Remote)

Aflac

Location: Remote - US only

Job Type: Full time

Posted


Job Summary

Provider Relations Representative will be assigned a territory where he/she is responsible for recruiting and developing a network of doctors that provide dental and vision benefits to our plan members.

Principal Duties & Responsibilities

  • Strategically identify and generate new leads for Provider recruitment to the Aflac D&V network by plan

  • Recruit and maintain an adequate Providers network in assigned regions by being able to explain the value in joining the Aflac D&V

  • Network

  • Obtain and submit accurate and completed Provider applications required for credentialing and contracting

  • Serve as the main point of contact between Providers and Aflac D&V

  • Conduct new Provider onboarding training to familiarize Providers with Aflac D&V processes and communication channels

  • Maintain and build strong business relationships with Providers and champion their requests to ensure a positive Provider experience

  • Must have the ability to work in a fast pace, high volume, production environment and maintain quality application processing.

  • Negotiate/Re-negotiate contracts and fees with Providers while being cognizant of utilization and cost

  • Supports and uses provider education materials which include: Perform network audit duties as necessary to ensure Provider directory accuracy and compliance with accreditation standards

  • As directed, take prompt action with the Provider Relations email inbox to ensure quick resolution

  • Track assigned duties and activities using the appropriate company resource (i.e. Acuity, Aldera, logging into phone systems, production reports etc.)

  • Perform Other duties and responsibilities as assigned by management

Education & Experience Required

  • High School Diploma or Equivalent

Education & Experience Preferred

  • 1-2 years of related experience
  • Some dental office billing experience highly preferred

Or an equivalent combination of education and experience

Job Knowledge & Skills

  • Ability to navigate complex health plan enterprise systems

  • Efficient and concise communication skills

  • Organized with excellent time-management capabilities

  • Strong analytical and problem-solving skills

  • Ability to analyze data for identifying trends and variance from goals

  • Ability to work autonomously

  • Detail-oriented

  • Ability to multi-task effectively

  • Microsoft Suite knowledge is a must

  • Bilingual English/Spanish a PLUS

Travel Required

≤ 10%

Competencies

  • Acting with Integrity - Clearly states goals and beliefs; lets people know his/her true intentions; does what he she said they would do; follows through on commitments
  • Communicating Effectively - Expresses ideas and information in a clear and concise manner; tailors message to fit the interests and needs of the audience; delivers information in a manner that is interesting and compelling to the listener
  • Pursuing Self-Development - Demonstrates ambition and desire to move forward in his/her career; engages others in discussions about career development; seeks feedback on ways to increase his/her performance; takes advantage of opportunities to build new skills and capabilities
  • Serving Customers - Builds strong relationships with customers; stays aware of customer needs, concerns and satisfaction; responds promptly to customer questions and requests; effectively manages
  • Supporting Change - Enthusiastically participates in new change initiatives and programs; focuses on reasons why changes will work and how they will be beneficial
  • Supporting Organizational Goals - Actively supports organizational goals and values; demonstrates enthusiasm toward the company's goals and mission; aligns actions around organizational goals
  • Working with Diverse Populations - Shows respect for the beliefs and traditions of others; encourages and promotes practices that support cultural diversity; discourages behaviors or practices that may be perceived as unfair, biased, or critical toward people with certain backgrounds
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