Provider Experience Specialist

Job Summary

Serving as the primary point of contact for dental providers, the full-time Provider Experience Specialist will manage escalated issues related to claims, credentialing, and payments while working remotely to ensure provider satisfaction and effective communication between teams.

Key Responsibilities

• Own escalated provider issues from intake through resolution, including tracking and root cause documentation
• Respond to provider inquiries on claims, eligibility, benefits, and payment disputes within defined turnaround standards
• Coordinate with claims, credentialing, and client services teams to resolve cross-functional issues

Required Qualifications

• High school diploma or equivalent required; associate degree or higher in business administration or healthcare administration preferred
• 1 to 3 years of experience in provider relations or dental/health plan operations
• Working knowledge of dental claims, CDT codes, and provider contracting concepts
• Familiarity with Medicare Advantage or Medicaid managed care requirements preferred
• Proficiency with CRM or ticketing tools and Excel