Insurance Contract Specialist

Company Description

At Gen4, we pride ourselves on our commitment to providing an incredible patient experience. We are passionate about our craft and the impact we can have on our patients. We aim to foster a doctor-centric organization that allows our doctors to do more of what they love. Culture, high performance, growth, and development are deeply embedded in our business and we have our sights set on finding individuals who are excited to be a part of a growing, flourishing company like ours. We offer competitive pay and a comprehensive benefits package available on the 1st of the month after 30 days of employment for full-time employees.

To learn more about us, check out our website here: https://gen4dental.com/

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 up-to-date with industry changes, regulations, and competitor activities that may impact 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 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.