Evaluate dental service requests and prior authorizations to determine medical necessity based on national clinical criteria. Document approval decisions and maintain productivity standards by completing 13 to 18 cases per hour.
Avesis
7 Remote Job Openings at Avesis
The Renewal Specialist will prepare and review underwritten packets, track renewals, and maintain database accuracy. They will also communicate with Underwriting and Account Management teams to ensure timely completion of tasks.
The Region Supervisor is responsible for the operational leadership and development of the Account Management team, ensuring high-quality service and achievement of departmental goals. They also manage a portfolio of strategic employer groups, focusing on relationship management and customer satisfaction.
The role is responsible for the overall ownership, administration, and monitoring of the EiPaaS/Bridgegate application to ensure compliant processing of 834 electronic files. It focuses on business process continuity, data integrity, and the optimization of electronic file integrations within the Operations department.
Regional Sales Manager, Northeast Region - OH, PA, MD, DC, VA
Avesis
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Full Time
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2 months ago
Avesis
Responsible for driving new business growth by selling commercial vision and dental programs to small and mid-group employers. This includes managing distribution partner relationships, delivering competitive proposals, and collaborating with internal teams to ensure smooth client onboarding.
The specialist will handle 40-60 inbound calls daily, addressing inquiries of routine to moderate complexity regarding dental benefits for Medicaid recipients, while accurately capturing and updating member information in systems. They must investigate and collaborate with internal teams to ensure issues are resolved, providing compassionate support and expert guidance to members accessing essential dental care services.
The specialist will handle 40-60 inbound calls daily, addressing inquiries of routine to moderate complexity regarding dental benefits for Medicaid recipients and ensuring accurate system data capture. They must investigate and collaborate with internal teams to resolve member issues, ensuring follow-up until a solution is provided.
