Dental Provider Relations Customer Service Representative Job Title Dental Provider Relations Customer Service Representative Duration Open Until Filled Location Portland, OR 97204 Other Location Job Class - P09/107 Description Lets do great things, together Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Currently, we are seeking a Professional Relations Representative for our Dental division. This role will be responsible for Provider fee filings and the fee filing database; creates and maintains provider files in various company systems; manages all Participation Agreements, and provider credentialing; responsible for resolution of National Provider File (NPF) weekly error report; maintains provider database for reports and mailings. Primary Functions: 01. Main contact with Oregon Providers for establishing Participating Agreements. 02. Responsible for the fee filing process, semi-annual updates, fee processing and communication with providers. Proofs daily report from the Filed Fee Database. 03. Responsible for dental PR queues. 04. Provides Customer Service for Providers and office staff inquiries. Establishes contact with providers to verify TIN when discrepancies exist and make changes via phone call, fax, or letter. 05. Reviews weekly NPF error report and corrects provider database. 06. Creates and maintains Oregon provider files in internal systems and provider database - add missing information, correct provider tax identification number (TIN) and other general corrections or updates for commercial and OHP providers. 07. Manages all facets of setting up Dental Clinics ensuring current and accurate data for all associated providers. 08. Maintains provider participation and DPO network status in internal systems, provider database. 09. Tracks credentialing and re-credentialing process for all providers. 10. Establishes hard copy files for all provider records, participating agreements, fees, credentialing and correspondence. 11. May assist with the recruitment of network providers. 12. Participates and contributes to various committees that are related to job role. 13. Performs other duties as assigned, such as special projects. Are you ready to be a betterist? If youre ready to make a difference that matters, we want to hear from you. Because its time to discover whats possible. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. Required Skills 1. High School diploma or equivalent. 2. At least 2 years office experience, preferably in a dental office or in a dental claims processing/support/customer service role. 3. Strong detail orientation skills, particularly with numbers. 4. Maintain production levels and accuracy. 5. Strong analytical problem solving skills. 6. Verbal, written, and interpersonal communication skills. 7. Ability to work well under pressure, work with frequent interruptions, and shifting priorities. 8. PC proficiency with Microsoft Office applications. 9. Typing skills of 35 wpm net. 10. 10-key skills of 135 spm net on a computer numeric keypad. 11. Ability to come into work on time and on a daily basis. 12. Maintain confidentiality and project a professional business image.