Call Center Representative - Remote Overview With more than 800 offices across 42 states, Aspen Dental continues to expand and grow every week in order to help millions of patients get the care they need, today. In order to accommodate patient demand and organizational growth, Aspen Dental Management, Inc. (ADMI), the dental support organization that provides business support to every Aspen Dental office, is looking for enthusiastic, dedicated and driven individuals who want to join a thriving organization, right from their own home! In an effort to best protect all of our employee and staff during this time, our full-time and part-time opportunities are now work-from-home. Virtual training classes begin soon so don't miss your chance to say YES to a career with Aspen Dental and make an impact in people's lives. You'll play a key role in helping offices streamline and consolidate practice efficiency, making it easier for dentists to focus on providing quality patient care....

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The primary role for TX Dental Fair Hearing Dental Consultant would be to oversee all state Fair Hearing cases for this Texas Medicaid dental carve out business. The contract requires that the dental consultant has knowledge of members appeal determination and to be able to provide clinical justification for this decision at the fair hearing. The TX Fair Hearing Dental Consultant would perform a clinical review of the case and provide an explanation and justification for the determination at a Fair Hearing Meeting. Most of the meetings will take place telephonically, however the state may require an in person hearing for special circumstances. Youll enjoy the flexibility to telecommute* from anywhere within Texas...

Welcome to one of the toughest andmost fulfilling ways to help people, including yourself. We offer the latesttools, most intensive training program in the industry and nearly limitlessopportunities for advancement. Join us and start doing your life s bestwork.SM Dental Member Advocates are responsible for first - level response and resolution ofescalated issues with external and internal customers. This position is full - time (40hours / week) Monday - Friday. Employees are required to have flexibility to workany of our 8 hour shift schedules during our normal business hours of 8:00am -5:00pm. It may be necessary, given the business need, to work occasionalovertime. If you are located in the El Paso, TX area, you will have theflexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The primary role for TX Dental Fair Hearing Dental Consultant would be to oversee all state Fair Hearing cases for this Texas Medicaid dental carve out business. The contract requires that the dental consultant has knowledge of members appeal determination and to be able to provide clinical justification for this decision at the fair hearing. The TX Fair Hearing Dental Consultant would perform a clinical review of the case and provide an explanation and justification for the determination at a Fair Hearing Meeting. Most of the meetings will take place telephonically, however the state may require an in person hearing for special circumstances. Youll enjoy the flexibility to telecommute* from anywhere within Texas...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The primary role for TX Dental Fair Hearing Dental Consultant would be to oversee all state Fair Hearing cases for this Texas Medicaid dental carve out business. The contract requires that the dental consultant has knowledge of members appeal determination and to be able to provide clinical justification for this decision at the fair hearing. The TX Fair Hearing Dental Consultant would perform a clinical review of the case and provide an explanation and justification for the determination at a Fair Hearing Meeting. Most of the meetings will take place telephonically, however the state may require an in person hearing for special circumstances. Youll enjoy the flexibility to telecommute* from anywhere within Texas...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The primary role for TX Dental Fair Hearing Dental Consultant would be to oversee all state Fair Hearing cases for this Texas Medicaid dental carve out business. The contract requires that the dental consultant has knowledge of members appeal determination and to be able to provide clinical justification for this decision at the fair hearing. The TX Fair Hearing Dental Consultant would perform a clinical review of the case and provide an explanation and justification for the determination at a Fair Hearing Meeting. Most of the meetings will take place telephonically, however the state may require an in person hearing for special circumstances. Youll enjoy the flexibility to telecommute* from anywhere within Texas...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) The primary role for TX Dental Fair Hearing Dental Consultant would be to oversee all state Fair Hearing cases for this Texas Medicaid dental carve out business. The contract requires that the dental consultant has knowledge of members appeal determination and to be able to provide clinical justification for this decision at the fair hearing. The TX Fair Hearing Dental Consultant would perform a clinical review of the case and provide an explanation and justification for the determination at a Fair Hearing Meeting. Most of the meetings will take place telephonically, however the state may require an in person hearing for special circumstances. Youll enjoy the flexibility to telecommute* from anywhere within Texas...

Primary Responsibilities: Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership Provide expertise and customer service support to members, customers, and/or providers Identify and resolves operational problems using defined processes, expertise and judgment Investigate claim and/or customer service issues as identified and communicate resolution to customers You’ll be rewarded and recognizedfor your performance in an environment that will challenge you and give youclear direction on what it takes to succeed in your role as well as providedevelopment for other roles you may be interested in. Required Qualifications: High School Diploma / GED (or higher) 2+ years of member advocacy experience 3+ years of Medicaid experience Intermediate level of proficiency with Microsoft Excel (create, edit, sort, filter spreadsheets and pivot tables) and Microsoft Word...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of Fraud/Abuse and other...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of Fraud/Abuse and other...

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your lifes best work.SM Dental Member Advocates are responsible for first-level response and resolution of escalated issues with external and internal customers. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. If you are located in the Lubbock or San Angelo, TX area, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of Fraud/Abuse and other...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of Fraud/Abuse and other...

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of Fraud/Abuse and other...

Position Description Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM Dental Member Advocates  are responsible for first-level response and resolution of escalated issues with external and internal customers. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. If you are located in the Lubbock or San Angelo, TX area, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Manage overall delivery of benefits and services by providing support and guidance to...

Position Description For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) Position will support Dental Utilization Management and Utilization Review by performing clinical review of member records, performing medical necessity review, providing clinical support to Fraud, Waste and Abuse, and remediating provider behavior. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review/audit member records to validate claims submission accuracy and identify potential quality of care issues Review/audit medical necessity review determinations made by dental consultants to determine if UHC review criteria were followed Lead the remediation of providers as the result of...