Vision Provider Relations Supervisor Job at Avesis, Incorporated
Join us for an exciting career with the leading provider of supplemental benefits!
Our Promise
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
The Provider Relations Supervisor (PRS) is tasked as part of the Provider Support Operations Department, to be the liaison between Avesis and the participating provider network. This role also will be responsible for coordinating efforts and assisting with the overall success of the Provider Relations Department to build and nurture positive relationships with the Avesis eye care community to include but not limit to best in class provider education and training, issues research and projects.
Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Essential Job Functions:
- Assisting the Vision Provider Relations Manager and leading the overall success of the Provider Relations Department, driving a positive Avesis provider experience and provider satisfaction
- Serve as a Subject Matter Expert (SME) and escalation point to coach Provider Relations/Services staff in providing the best service experience and timely issue resolution possible
- Accountable leader for the Provider Relations/Services staff in their effectiveness, career development, and team morale
- Partner with cross-functional departments to develop and implement operational improvements to daily workflows
- Accountable leader to the Provider Relations/Service’s team success to include department operational, quality, and individual KPIs
- Conducts provider outreach by providing training and guidance to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools
- Responds to general provider contract inquiries, provider education and non-routine claim issues and may research, analyze, and recommend resolution for provider disputes
- Ability to review and negotiate fee exceptions
- Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues
- Working knowledge of credentialing process
- Investigate and respond to complex provider related issues and initiate change of provider related database information
- Knowledge of and ability to use various computer programs such as Microsoft Office including spreadsheet, word processing and presentation software and programs/systems utilized in data analysis
- Ability to prioritize and organize a diverse workload required
- Excellent verbal and written communication and effective listening skills required
- Other duties as assigned
Requirements:
- Bachelor’s Degree; experience may substitute for education
- Minimum of 3-5 years of vision/hearing industry experience
- Knowledge of health plan operations
- Strong skills in using Microsoft Office applications and other windows-based applications
- Self-Starter with ability to work independently and as part of a team
- Must be highly organized, detail oriented and a self-starter with strong managerial skills and a track record of success in a fast-paced organization
- Excellent time management skills
- Excellent verbal and written communication skills
- Ability to travel nationally as needed, up to 50% to interview new staff, attend and evaluate team member site visits or support staff in trade show efforts and perform daily responsibilities
Essential Job Functions:
- Assisting the Vision Provider Relations Manager and leading the overall success of the Provider Relations Department, driving a positive Avesis provider experience and provider satisfaction
- Serve as a Subject Matter Expert (SME) and escalation point to coach Provider Relations/Services staff in providing the best service experience and timely issue resolution possible
- Accountable leader for the Provider Relations/Services staff in their effectiveness, career development, and team morale
- Partner with cross-functional departments to develop and implement operational improvements to daily workflows
- Accountable leader to the Provider Relations/Service’s team success to include department operational, quality, and individual KPIs
- Conducts provider outreach by providing training and guidance to enable Avesis network providers to become more self-sufficient in confirming eligibility, claims submission and payment by use of available tools
- Responds to general provider contract inquiries, provider education and non-routine claim issues and may research, analyze, and recommend resolution for provider disputes
- Ability to review and negotiate fee exceptions
- Understanding of health insurance claims, as well as an ability to analyze data to resolve provider service issues
- Working knowledge of credentialing process
- Investigate and respond to complex provider related issues and initiate change of provider related database information
- Knowledge of and ability to use various computer programs such as Microsoft Office including spreadsheet, word processing and presentation software and programs/systems utilized in data analysis
- Ability to prioritize and organize a diverse workload required
- Excellent verbal and written communication and effective listening skills required
- Other duties as assigned
Requirements:
- Bachelor’s Degree preferred; experience may substitute for education
- Minimum of 3-5 years of vision industry experience
- Knowledge of health plan operations
- Strong skills in using Microsoft Office applications and other windows-based applications
- Self-Starter with ability to work independently and as part of a team
- Must be highly organized, detail oriented and a self-starter with strong managerial skills and a track record of success in a fast-paced organization
- Excellent time management skills
- Excellent verbal and written communication skills
- Ability to travel nationally as needed, up to 50% to interview new staff, attend and evaluate team member site visits or support staff in trade show efforts and perform daily responsibilities
We Offer
- Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
- Competitive compensation package.
- Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
- Life and disability insurance.
- A great 401(k) with company match.
- Tuition assistance, paid parental leave and backup family care.
- Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
- Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
- Employee Resource Groups that advocate for inclusion and diversity in all that we do.
- Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.
Equal Employment Opportunity
At Avēsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avēsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avēsis, where We See You!
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