Provider Services Advocate

The Provider Advocate is responsible for providing a concierge level of provider experience, while striving to provide first call resolution to requests related to provider recruitment, contracting and credentialing for all Delta Dental and Dentegra products. The incumbent provides awareness, education and promotes all Delta Dental fee for service and managed care products including PPO/Premier, DeltaCare USA, Medicare Advantage, Medicaid, Federal Programs and Dentegra, as providers inquire and progress through the recruitment, contracting and credentialing process, as well as when they become effective (should it be "active") in Delta Dental and Dentegra provider networks.

• Provides prompt, first-call resolution, at a concierge level provider experience, to provider inquiries and complies with department metrics, service level agreements, and documentation guidelines for all calls as assigned, including but not limited to contract inquiry, fee schedule requests and contract fulfillment.
• Complies with department standard turn-around-time commitments and documents all provider interactions in appropriate PEGA P360 cases.
• Appropriately redirects inquiries, either those received by call transfer, email or Macess to the correct and appropriate functional area.
• Escalates to Network Development Specialist and/or Sr. Provider Advocate as appropriate, based on the type of inquiry received.
• Promotes the use of Delta Dentals digital tools, including, but not limited to Provider Tools, direct deposit.
• Requests and updates provider email addresses.
• Assists with provider sign-on issues and resets passwords when necessary.

• 1+ years of experience w/High School.
• A minimum of 2 years related experience (Managed Care or Medical/Dental Insurance experience); plus a minimum of 3 years of related experience working in a large dental or medical plan, provider relations, and operations (claims & customer service).
• Strong organizational/time management skills and multi-tasking abilities.
• Analytical and problem-solving skills and the ability to make decisions with limited information.
• Strong written, verbal, interpersonal and phone skills.
• Detail orientation with mathematical, reading, and comprehension skills.
• Knowledge of Current Dental Terminology (“CDT”) codes and dental nomenclature.
• Ability to type 40 words per minute with no more than two errors per entry.
• Knowledge of the company’s claims processing systems, claims flows and adjustment notices.

Base Pay Information

The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental’s assessment of the candidate’s knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. 

Pay Grade 15. $40,500 - $84,800

Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes:

• Competitive base and incentive pay 
• 401(k) with robust matching and non-matching contributions
• Rich medical & pharmacy benefits
• 100% employer-paid dental and vision benefits
• Holistic wellbeing program with deep financial incentives
• Generous paid time off plus 12 paid holidays and your birthday off
• Culture of growth and learning: career development; tuition reimbursement; recognition program
• Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
• Social responsibility and volunteer opportunities
• Employee discount program

Fair Chance Ordinances and Criminal Background Considerations  This position requires that the applicant undergo a background check. Qualified applicants with arrest or conviction records will be considered for employment in accordance with any applicable federal, state or local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and/or New York Corrections Law Article 23-A.
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