Join the #1 company in New York's dental insurance market! Healthplex offers excellent career opportunities in an organization that provides career advancement and training programs while recognizing and rewarding strong performance. We offer competitive compensation and benefits packages and new executive management is dedicating time and resources to making Healthplex the best place to work on Long Island.

Current Career Opportunities

Administrative Support /Purchasing

Position Title:

Administrative Support /Purchasing

Reports To:

Purchasing Manager

FLSA Status:

Non-Exempt

Summary:

Responsible for the day to day administrative support /purchasing tasks.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Generates and tracks Purchase Orders as directed by Purchasing Manager.
Assists with all aspects of Contract Administration, including disaster recovery manuals.
Assists with invoice reconciliation.
Compile comparative pricing for review as needed.
Maintain integrity of inventory Purchase Order records (ie. Basement inventory, item change forms).
Responsible for ensuring that all documents are saved in the appropriate file archives.
Perform other general administrative duties in support of the Purchasing Department as assigned.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High School Diploma experience in purchasing and inventory management a plus.

Computer Skills:

Knowledge of Outlook Contact Management systems; and proficiency in Microsoft Software programs - Word, Excel, Access and Outlook. A working knowledge of Navision or other inventory management/purchasing systems is a plus.

Other Skills:

Strong attention to detail. Must have ability to multi-task and learn quickly.

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Bilingual Customer Service Representative

Position Title:

Bilingual Customer Service Representative

Reports To:

Director of Customer Service

FLSA Status:

Full Time

Summary:

A Bilingual Customer Service Representative must be able to speak/read/write in English as well as one of the following: Spanish, Russian, Mandarin, or Cantonese. A Bilingual Customer Service Representative assists our members in an inbound call center by investigating and responding to all member inquiries regarding dental plan coverage, status of claims, provider information, and any other information that will assist our members. Customer Service Representatives are full time employees scheduled for 35 hours a week. We are currently looking to fill positions for Monday-Friday from 10:30am to 6:00pm. Paid training will be the first seven business days of employment from 9:00am to 4:30pm.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Efficiently answer inbound calls while resolving member issues concerning their dental coverage
Handle irate customers in a professional manner
Adhere to all attendance/punctuality policies and procedures
Absorb and retain information to ensure consistency when explaining benefits, regulatory items, and policy and procedures
Meet or exceed standards of quality and professionalism as set by both Healthplex and the NCQA
Provide professional and courteous service to all lines of business
Ensure consistency and adherence to departmental work flows, policy and procedures
Follow appropriate avenues of protocol to elevate issues
Input comments regarding customer issue and relative data into the database
Call customers when necessary to advise on next steps and/or inform of resolution
Obtain customer feedback information and multi task while on the phone

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High School diploma or GED. Preferred Experience: 1 year of Customer Service Call Center experience. Experience working in Dental Office and/or HMO/Insurance

Computer Skills:

Basic computer skills as well as quick and accurate typing skills.

Other Skills:

Fluent (speak/read/write) in English as well as Spanish, Russian, Mandarin, or Cantonese. Excellent communication skills (good grammer, voice, and diction). Excellent customer service skills (friendly, courteous, and helpful).

Apply Now

Clinical Analyst - Part Time

Position Title:

Clinical Analyst - Part Time

Reports To:

President of Dentcare

FLSA Status:

Non-Exempt

Summary:

A Clinical Analyst is responsible for reviewing dental claim forms, treatment plans and other documents relating to the provision of dental services and imposes, wherever applicable, the exclusions and limitations of the Company's dental benefit plans.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Utilize Dental knowledge to provide, review and interpretation of Claims files and Dentcare Audit of Healthplex Utilization Review Determination Files.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

Bachelor of Science Degree (B.S.) plus 2-4 years' experience or equivalent combination of education and experience in the dental healthcare industry. Clinical background preferred must have Dental Hygienist (R.D.H.), Certification

Computer Skills:

Proficiency in Microsoft Software programs ? Word, Excel, Access, and Outlook.

Other Skills:

Ability to work as part of a team. In-depth knowledge of dental procedures and terminology. Excellent communication skills.

Apply Now

Clinical Reviewer (Licensed Dentist)

Position Title:

Clinical Reviewer (Licensed Dentist)

Reports To:

Director of Utilization Management

FLSA Status:

Non-Exempt, Part-Time

Summary:

The primary function of the Clinical Reviewer is to review dental claim forms, treatment plans and other documents relating to the provision of dental services and impose, wherever applicable, the exclusions and limitations of the Companys dental benefit plans.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Review documents submitted by managed care and fee-for-service dentists in the manner set forth in the Companys policies.
Respond on a timely basis to inquiries from staff members regarding the provision of services to enrollees.
If requested, to participate as a member of the Quality Improvement Committee.
If requested, to participate as a member of the Utilization Review Committee.
If requested, to participate as a member of the Complaint and Appeals Review Committee.

Qualifications:

Licensed as a dentist under the laws of the State of New York, authorized to practice dentistry and currently approved by the Department of Education of the State of New York
or;
Licensed as a dentist under the laws of the State of New Jersey, authorized to practice dentistry and currently approved by the Department of Law & Public Safety, Division of Consumer Affairs of the State of New Jersey.
Have no history of any Medicaid/Medicare and/or other governmental regulatory sanctions.
Be properly credentialed by a Credentials Verification Organization.
Maintain a knowledge of current dental procedures, terminology and treatment codes.

Education And/Or Experience:

Be a graduate of an accredited dental school.
Have a minimum of ten (10) years experience in the dental field.

Computer Skills:

Other Skills:

All qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

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Credentialing Assistant

Position Title:

Credentialing Assistant

Reports To:

Director of Credentialing - Healthplex, Inc.

FLSA Status:

Non-Exempt, Non-Union

Summary:

A Credentialing Assistant processes provider information as directed and provides general administrative support to the Credentialing department.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Performs application data entry with strong attention to detail.
Handles follow-up phone calls to providers.
Primary source verification for state licenses, DEA certificates, malpractice insurance and sanctions
Mailing of provider applications.
Filing and scanning of provider information.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High school diploma or GED

Computer Skills:

Basic computer skills. Familiarity with a keyboard. Excellent verbal communication skills and phone etiquette.

Other Skills:

All qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

Apply Now

Customer Service Representative

Position Title:

Customer Service Representative

Reports To:

Director of Customer Service

FLSA Status:

Full Time

Summary:

A dental Customer Service Representative receives, investigates and responds to all customer inquiries regarding dental plan coverage, status of claims and provider information.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Talk with customers by phone concerning dental plan coverage issues.
Input comments regarding customer issue and relative data into the database.
Call customers when necessary to advise on next steps and/or inform of resolution.
Handle irate customers in a professional manner.
Obtain customer feedback information.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High school diploma or GED.

Computer Skills:

Basic computer and keyboarding skills.

Other Skills:

Knowledge of dental procedures and terminology. Excellent communication skills. Good grammar, voice and diction. Bi-lingual English/Spanish/Russian helpful. Excellent customer service skills (friendly, courteous and helpful).

Apply Now

Equal Employment Opportunity:

Healthplex is committed to equal employment opportunities. It is Healthplex's policy to prohibit employment discrimination, including but not limited to harassment on the basis of age, ancestry, color, marital status, (including civil union status), national origin, race, religious creed, sex, sexual orientation, disability, veteran status, citizenship status or any other characteristic protected by law.