Dental Payer Relations Specialist
Company: Great Expressions Dental Centers
Location: Southfield
Posted on: July 30, 2022
Job Description:
Great Expressions Dental Centers (GEDC) is one of the most
established, single brand dental organizations in the United
States. - Founded in Michigan over 45 years ago and now serving
patients in nine states across 250 dental offices, the Great
Expressions strategic objective is to become the leading national
Dental Services Organization-fueled by the Best Team Members
working in a Best Place to Work culture that culminates in
delivering the Best Patient Experience in the industry. -An
experienced negotiator, the Senior Dental Payer Relations
Specialist position (remote setting ok) is accountable for working
with the VP, Payer Relations and Credentialing to support all
aspects of payer contracting strategies and payer fee negotiations
for Great Expressions Dental Centers (GEDC) that support revenue
growth. -
Lead payer contract fee negotiations
and renegotiationsBuild and maintain payer analytics capability to
benchmark utilization and reimbursement levels across the growing
GEDC 250-office networkEvaluate new payers/networks and their fees
for participationWork with outside consultants and contracted
third-parties with respect to payer relationsThoroughly analyze and
review rates and utilization in order to drive mutually beneficial
outcomes for dental patients and providersAnalyze fee schedules by
specialty and code relative to historical company utilization and
industry compsTrack contracts and anniversary dates to ensure
annual rates are implemented correctly and on timeQuantify rate
impacts during negotiations and monitor ongoing utilization and
expected fee changesAssist in developing and maintaining
appropriate policies, procedures, and controls for dental contracts
and payer contracting activityBuild large data models to forecast
and monitor payer rates by codeBuild and deepen relationships with
key contacts at payers through ongoing communications; keep a
record of conversations with payers, schedule periodic phone calls
and update payer contact listsResolve escalated issues with
payersRun and distribute revenue, impact analysis and other
reportsAudit invoices from consultants and submit for
paymentDevelop presentations to report on progress and resultsOther
duties as assignedRequired Skills/Abilities:
Analytical ability and experience
managing large data sets Track record of success working in an
environment of collaboration, transparency, mutual respect, and
passion for excellence and innovationMust be able to communicate
and work effectively with all levels of employees and
managementStrong organizational, project planning and project
management skills are requiredProven ability to translate
high-level business requirements into an operational
product/serviceExcellent financial and business acumenExperience in
healthcare is preferred, but not requiredEducation & Experience:
2-3 years of experience with a DSO
(Dental Service Organization) requiredPrior fee analysis and
negotiations experience requiredBachelor's degree required,
preferably in a quantitative field; MBA or advanced degree a
plusAdvanced Excel skills are a mustActuarial
experience/qualifications highly desirableStrong organizational
skills, accuracy and attention to detailHigh level of maturity,
personal initiative, and sound judgmentStrong work ethicDental
experience and a knowledge of CDT codes and dental terminology
requiredDental EHR system experience is a plusComfort level with
using Power BI, think-cell, VBA Macros a plusSalary commensurate
with experience
Keywords: Great Expressions Dental Centers, Southfield , Dental Payer Relations Specialist, Healthcare , Southfield, Michigan
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