Bilingual Provider Relations Representative - Homeland LLC : Job Details

Job Summary

Homeland has partnered with a leading provider of employee benefits, specializing in dental health coverage for millions across the U.S. Our client is seeking a Bilingual Provider Relations Representative (PR2) to join their team.

The Bilingual Provider Relations Representative (PR2) serves as a key liaison between our Client and their participating provider network within the Provider Support Operations Department. This role focuses on building and nurturing strong relationships with the community of eye care, dental, and hearing providers. Responsibilities include delivering best-in-class provider education and training, conducting issue research, and managing various projects. The PR2 position is hybrid, requiring both remote work and field travel to support provider relationships and initiatives effectively.

Responsibilities

• Oversee diverse provider administrative duties to enhance the provider experience, focusing on direct engagement and training to resolve issues
• Conduct provider outreach through in-person meetings, video calls, phone, or email, providing training, orientation, and coaching to improve performance within provider practices
• Guide providers in becoming self-sufficient in confirming eligibility, claims submission, and payment using available tools
• Organize monthly and/or quarterly meetings with provider groups, documenting discussions, issues, attendees, and action items; research claims or prior authorization issues onsite and route to the appropriate party for resolution
• Manage relationships and performance for assigned provider groups, serving as their primary point of contact
• Communicate and share provider reporting
• Conduct provider orientation for all applicable product lines to train staff and resolve issues
• Act in a supportive role for the assigned provider territory
• Perform onsite facility reviews when applicable and conduct quarterly face-to-face visits within the assigned territory and/or market
• Collaborate with various teams including Claims, Customer Service, Utilization Management, Clinical Management, Credentialing, Recruitment, and Account Management to develop operational solutions for various provider network projects
• Maintain knowledge of the provider credentialing and contracting process
• Educate providers about state programs, group policies, health plan policies, and compliance requirements regarding state and federal regulations
• Investigate and respond to complex provider-related issues and update provider demographic database information as needed
• Address general provider contract inquiries, provide education, and resolve non-routine claim issues
• Understand health insurance claims and analyze data to resolve provider claim issues
• Utilize various computer programs, including Microsoft Office (spreadsheets, databases, word processing, and presentation software) and systems for data analysis
• Attend work-related events and conferences, representing the organization and brand professionally
• Analyze, prioritize, and organize a diverse workload
• Provide guidance or expertise to less experienced representatives as needed
• Exhibit excellent verbal and written communication and effective listening skills
• Ability to travel as required
• Perform other duties as assigned

Requirements

• Bachelors Degree (experience may substitute for education)
• Bilingual, preferred
• Ability to travel within a specified geographic territory, up to 50%
• Previous experience in dental, vision, or hearing office administration (preferred)
• Knowledge of health plan operations (preferred)
• Familiarity with provider and health plan contracts/agreements (preferred)
• Excellent communication skills
• Understanding of medical, dental, and vision terminology
• Customer service and communication oriented
• Strong proficiency in Microsoft Office applications, with intermediate skills in Microsoft Excel and database management
• A valid driver's license and the use of your own vehicle are required.

Additional Information

You must be able to travel up to 50% to meet prospective clients, current customers, and attend trade shows and meetings as needed. Travel requirements may vary throughout the year, ranging from short or overnight trips to extended stays in different regions for project or client implementation and customer support. Modes of transportation may include public options such as rail, bus, car, and/or plane. Travel and mileage reimbursement will be provided in accordance with IRS annual mileage guidelines and/or receipts submitted through the company expense report policy.

Benefits

Our client provides meaningful and challenging work that fosters innovation in a secure and compliant environment, alongside a competitive compensation package. Benefits include comprehensive medical, dental, vision, life, and disability coverage for employees and their dependents with no waiting period, a 401(k) plan with company match, tuition assistance, paid parental leave, and backup family care. Their collaborative workspaces encourage creativity and talent development, while flexible time off, dress code, and work location policies promote work-life balance. The company values inclusion and diversity through Employee Resource Groups and is dedicated to social responsibility, community outreach, educational partnerships, and sustainability efforts.

Summary

Apply today!

EEO Notice

Homeland LLC is an Equal Opportunity Employer. Homeland LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws. Homeland LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.