Insurance Contract Specialist
Insurance Contract Specialist
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Job Description
The Insurance Contract Specialist is instrumental in developing and executing comprehensive payer strategies to enhance market positioning drive revenue growth and ensure optimal reimbursement for our dental health services. The Specialist must have a deep understanding of the dental industry payor landscape and a proven track record in developing and implementing successful payor strategies. The Specialist will deliver sustainable impactful data and reports while building strong partnerships to further analytics efficiency gains and strategic initiatives.
Job Highlights:
Create dashboards scorecards spreadsheets and practice analysis reports which will directly influence Best Practice results.
Pull data and complete UCR and Payor Mix Analysis to ensure payor optimization for each practice.
Monitor and manage payor contracts and fee schedules; identify opportunities for renegotiation or improvement.
Manage UCR Fee Schedules and Analysis; maintain Master UCR Fee spreadsheet
Create payor scorecard to track AR Aging AR Days by Payor
Utilize data analytics to assess the financial impact of payor contracts and identify areas for improvement.
Generate and present regular reports on key performance indicators related to payor strategies.
Conduct market analysis to identify trends opportunities and threats in the dental health payor landscape.
Collaborate with the Manager Payor Relations to negotiate favorable contractual agreements reimbursement rates and terms. Responsible for implementing contacts and fee schedules with the practices in a seamless manner.
Stay uptodate with industry changes regulations and competitor activities that may impact payor strategies
Qualifications :
Bachelors degree in Business Healthcare or related field or equivalent experience
5 years experience working directly with Payors Contracting Provider Relations and/or Provider reimbursement experience; preferably in the dental industry
Proficient in Excel and Microsoft Word
Fluency in Power BI and/or Dental Intel reporting
Strong analytical skills data presentation/visualization and technical capabilities that allow summarization and interpretation of data to formulate for presentations
Travel Requirement:
Limited
Additional Information :
Working conditions include those typically seen in an office environment. Prolonged periods of sitting at a desk and working on a computer. Must be able to lift to 15 pounds at times.
Equal Opportunity Employer
Gen4 Dental Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
