Provider Data Representative - Cigna Healthcare - Remote

This production role delivers professional activities in the Provider Contracting job family.

The position is responsible for dental provider recruitment.

Conducts daily outreach to dental offices or providers to develop and maintain positive relationships with the purpose of negotiating a contract for participation in our dental networks (DHMO and DPPO).

Assists with new provider or location credentialing, contracting and recredentialing requests.

Respond to status requests and other non-routine contract questions.

Assists with preparation or modification of provider compensation or contracts.

Completes output in specific work area to appropriate time and quality targets.

Works under own initiative, prioritizes own work, and meets agreed timescales.

Work is subject to frequent review by more experienced professionals in Provider Contracting.

Responsibilities include, but not limited to:


* Identifying, recruiting, and contracting, qualified health care professionals in geographic area within established guidelines to meet health plan needs


* Handle incoming calls from dental providers, reroute misdirected calls


* Takes ownership of issues and works to resolve them over the phone with a "one and done philosophy".


* Perform research and interpret guidelines to respond to inquiries, complaints or disputes, ensuring compliance


* Outreach to providers to obtain missing or additional information to ensure applications and contracts meet compliance


* Collaborate with internal departments as needed


* Maintain positive relationships with health care professionals and their office staff extending high quality service

Qualifications:


* High School Diploma or GED Required


* Minimum of 3 months experience in dental office negotiations, relations or contracting


* Ability to multi-task and priorities workload


* Strong verbal and written communication skills


* Must be a current Cigna or Express Scripts contractor


* Basic to intermediate proficiency in Microsoft Office products


* Demonstrates ability to manage multiple tasks simultaneously while maintaining quality service


* Candidates must have a hard-wired internet connection to plug into the equipment - Wi-Fi will not suffice.


* Satellite internet is not compatible with the equipment and internet speeds must be at least 25Mbps Download/5Mbps Upload.


* Candidates MUST be available/focused consistently during working hours unless otherwise agreed upon with minimal distractions.

Computer knowledge should include being able to set up equipment and troubleshoot with IT regarding any issues as they will be responsible for the set up.


* Please indicate location on resume and confirm internet requirements are met.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbp...