Dental Services Representative

Company: Vantage Health Plan, Inc. ( Learn More )

General Information
High School
At least 2 year(s)
Not Specified
Job Description

At Vantage Health Plan, we specialize in taking care of people: our members, our patients, and our employees. We offer competitive salaries and great benefits! Benefits include: Health, Dental, Life, Accidental Death and Dismemberment, Long Term Disability, Paid Time Off, and 401(k).

Vantage is currently looking for a Dental Services Representative to work at our Hudson Lane location from 8:00AM – 5:00PM, Monday through Friday. 

Job Summary: The Dental Services Representative is responsible for managing a high volume of calls and questions regarding Dental Providers, Dental services, and claims via email, telephone and fax. Also, the Representative works independently and with the team to manage the existing provider network.

Essential Duties & Responsibilities:
  • Answer phone calls from Providers regarding their claims, benefits, and authorizations by researching & working with other various Departments to make sure that they are processed correctly.
  • Research and respond to problem emails from various Departments regarding Dental services.
  • Work independently and within a team on special nonrecurring and ongoing projects.
  • Work inter-departmentally among Member Services, Claims, Provider Services, and with the Medical Directors to handle claim problems and questions. 
  • Work with providers daily to help with benefits, allowables, accumulators, and claims filing processes. 

  • Marginal Duties:
  • Assist Medical Management Supervisor, Director, and Dental Network Development Representative with various projects and other responsibilities as needed.
  • Assist Appeals team with dental appeals.
  • Advise Claims department with Dental services such as COB, and correct claim processing.
  • Other duties as required. 
  • Job Requirements

    Knowledge, Skills, and Abilities:

    • Previous experience working with dental insurance and/or in a dental office setting required
    • High School Diploma or GED with 2 years business experience.
    • Excellent verbal and written communication skills.
    • Ability to use Microsoft Office, Excel, Outlook, Publisher, Work, Access, PowerPoint and Internet.
    • Excellent interpersonal skills.
    • Experience handling a high call volume.
    • Ability to organize and manage multiple priorities.
    • Ability to interact effectively with all staff and other professionals.
    • Ability to work under stress.

    Supervisory Responsibilities
    • None

    Supervision Received
    • Works under general supervision of Medical Management Supervisor and occasional supervision of the Medical Management Director.
    • Overtime may occasionally be required.
    Working Conditions

    Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel, reach with hands and arms, and talk or hear. The employee is frequently required to stand and walk. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 25 pounds.