Offer summary

Qualifications:

Bachelor’s degree in business, Healthcare Administration, or a related field preferred., Minimum of 7 years of experience in billing, coding, or payor claims resolution in the dental industry., Strong understanding of dental billing procedures and insurance claim processes., Excellent analytical, problem-solving, and communication skills are essential. .

Key responsabilities:

Investigate and resolve payment discrepancies by analyzing billing errors and insurance claim rejections.

Work closely with dental practices to provide guidance on proper billing procedures and compliance.

Act as the liaison between dental offices and insurance carriers to facilitate communication and resolve payment issues.

Monitor billing data for trends and prepare reports for management on key findings and recommendations.

Job description

Overview:

We are seeking a detail-oriented and analytical Insurance Plan Management Operations Specialist with deep knowledge of the dental industry to join our dynamic team. In this role, you will be responsible for troubleshooting payment discrepancies arising from incorrect dental billing by our offices or inaccuracies in dental insurance carrier payments. Your expertise will help streamline our billing processes and improve our overall revenue cycle management. This is a remote position.

Dental Care Alliance’s mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA currently supports over four hundred allied practices and supports over nine hundred dentists across over 20 States. DCA’s allied practices represent all dental specialties and treat patients under more than 150 brand names.

Responsibilities:

Core Competencies:

· Industry Knowledge: In-depth understanding of dental insurance industry practices, regulations, and trends.

· Analytical Skills: Strong analytical and problem-solving abilities to interpret credentialing data, identify trends, and make informed decisions to optimize the new provider experience. Microsoft Office (Excel, PowerPoint, Visio) proficiency required.

Expectations:

· Troubleshoot Payment Issues: Investigate and resolve payment discrepancies by analyzing billing errors, payment discrepancies, and insurance claim rejections.

· Communication and Collaboration with DCA Dental Offices and Revenue Cycle Team: Work closely with our dental practices to provide guidance on proper billing procedures, ensuring compliance with industry standards and best practices.

· Insurance Carrier Liaison: Act as the point of contact between the dental offices and insurance carriers, facilitating communication and ensuring timely resolution of payment issues.

· Analyze Billing Data: Monitor and assess billing data for trends in discrepancies and errors, providing insights and recommendations for process improvements.

· Documentation and Reporting: Maintain accurate records of payment issues, resolutions, and communications with stakeholders; prepare reports for management on key findings and trends.

· Training and Support: Conduct training sessions for dental office staff on billing protocols and effective claim submission practices to minimize future issues.

· Stay Updated: Keep abreast of changes in insurance policies, billing regulations, and industry standards to ensure compliance and optimize operations.

Qualifications:

· Education: Bachelor’s degree in business, Healthcare Administration, or a related field experience preferred.

· Experience: Minimum of 7 years of experience in billing, coding, or payor claims resolution in the dental industry.

· Knowledge: Strong understanding of dental billing procedures, insurance claim processes, and relevant regulations.

· Skills: Excellent analytical and problem-solving skills, with a keen attention to detail. Strong communication and interpersonal skills are essential for effective collaboration with internal teams and external partners.

· Technical Proficiency: Proficient in dental practice management software and Microsoft Office Suite is a must. Familiarity with payor reimbursement policies and how to navigate and communicate changes is essential.

Required profile