Teams at Avēsis

Primary contact for members, providers, and clients managing dental and vision appeals and grievances. Review records and coding, apply policies and state guidelines, draft formal correspondence, coordinate with clinical and operational teams, refer medical necessity denials, prepare external review requests, and ensure timely, compliant case resolution.

Provide compassionate bilingual (Spanish) customer service to Medicaid dental members via inbound calls. Capture and update member data, research and escalate complex issues, ensure HIPAA compliance, navigate healthcare programs and systems, and work scheduled Eastern Time shifts in a 100% remote call center.

Provide compassionate inbound phone support to Medicaid dental members in a high-volume remote call center. Answer 40-60 calls daily, document interactions, research and escalate unresolved issues, collaborate with internal teams, maintain HIPAA confidentiality, and adapt to changing programs and business rules.