Full-Time Insurance Contract Specialist

The Insurance Contract Specialist is key in creating and executing comprehensive payer strategies to boost market position, increase revenue, and guarantee optimal reimbursement for our dental health services.

The Specialist must have strong knowledge of the dental industry, payor landscape, and a proven history of developing and implementing successful payor strategies.

The Specialist will deliver impactful data and reports while creating strong partnerships to further analytics, efficiency gains, and strategic initiatives.

1. Job Highlights: Create dashboards, scorecards, spreadsheets, and practice analysis reports that directly influence Best Practice results.
2. Pull data and complete UCR and Payor Mix Analysis to ensure payor optimization for each practice.
3. Monitor and manage payor contracts and fee schedules; identify opportunities for renegotiation or improvement.
4. Manage UCR Fee Schedules and Analysis; maintain Master UCR Fee spreadsheet.
5. Create payor scorecard to track AR Aging, AR Days, by Payor.
6. Utilize data analytics to evaluate the financial impact of payor contracts and pinpoint areas for improvement.
7. Generate and present regular reports on key performance indicators related to payor strategies.
8. Conduct market analysis to identify trends, opportunities, and threats in the dental health payor landscape.
9. Collaborate with the Manager, Payor Relations to negotiate favorable contractual agreements, reimbursement rates, and terms.
10. Responsible for implementing contacts and fee schedules with the practices in a seamless manner.
11. Stay updated on industry changes, regulations, and competitor activities that may affect payor strategies.

Qualifications:

• Bachelor’s 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 for summarizing and interpreting data to formulate presentations.

Additional Information:

• Limited travel required.
• Typical office environment with prolonged periods of sitting.
• Able to lift up to 15 pounds occasionally.
• Equal Opportunity Employer

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