Provider Relations Representative - Come Grow With Us

COME GROW WITH US! Healthplex, Inc. a growing dental plan provider has an exciting opportunity in our Provider Relations department for an individual with a sales and/or recruitment background.
About HealthplexHealthplex is known as "The Dental Plan Specialists." The company was established in the 1970's by dentists and other healthcare professionals who were concerned about the increasing costs of dental care. With an understanding of dentistry as well as dental insurance, Healthplex was able to develop benefit plans that effectively managed the risks associated with conventional indemnity plans. One million subscribers later, the corporation is providing dental benefits and administrative services for insurance companies, HMOs, school districts, municipalities, welfare funds and businesses of all sizes.
In New York, dental plans are underwritten by Dentcare Delivery Systems, Inc., a not-for-profit Health Services Corporation, Healthplex Insurance Company, the United States Life Insurance Company and other licensed organizations. In New Jersey, benefits are available through our wholly owned Dental Plan Organization, International Healthcare Services, Inc. In addition to dental benefits and administrative plans, Healthplex maintains one of the largest Preferred Provider Organizations in the Northeast. The company is also certified as a Credentials Verification Organization in eleven out of eleven credentialing elements by the National Committee for Quality Assurance. The National Committee for Quality Assurance is an independent, non-profit organization that certifies credentials verification organizations and accredits managed care organizations.Visit our website at www.healthplex.comProvider Relations Representative / Recruiter
As a Provider Relations Representative you will be responsible for building and maintaining dental provider panels by initiating and maintaining effective channels of communication with participating and prospective providers. Candidates for this position will need exceptional communication skills including negotiation skills.


ESSENTIAL DUTIES AND RESPONSIBILITIES:
Include the following. Other functions may be assigned as business conditions change.
Periodically visit provider offices to orient office staff in policies, fee schedules and claims processing
Handle provider contracts and negotiate fee schedules as well as fee increasesCommunicate with panel doctors regarding plan changes and other issues
Validate and authorize all changes to the Oracle Provider Database by accurately updating top sheets
Respond to providers regarding participation, fees and special requests
Support Customer Service in Quality of Care issues
Interface with multiple departments (e.g. management, claims, customer service, credentialing and marketing) to research and resolve provider issues or to assist with special project, such as recruitment to support member growth.Maintain complaint records for HMO and state reporting
Reduce risk through quality assurance program
Develop and maintain directory data for all Locals and PPO groups
REQUIREMENTS


Healthplex offers excellent compensation and working conditions. Employee benefits at Healthplex, Inc include:Generous paid time offMedical Insurance Free dental coverage401K Plan with employer contributionsGroup term life insurance

Send your resume and salary requirements to Attn: HR fax/e-mail (516)228-1744,