Affordable Care

  • Insurance Specialist/Trainer

    Job Locations US-NC-Raleigh
    Job ID
    2018-4526
    Category
    Healthcare Support
  • Overview

    Insurance Specialist/Trainer

     

    Position Summary:

    Insurance Services Department Consultants share their expertise and give advice to ACI affiliated dental practice staff with the aim of optimizing  insurance participation and the revenue cycle.  They develop tools, deliver training, and provide on-going assistance to ensure practice level proficiency in plan administration and revenue maximization.  Affordable Care is a fast paced, dynamic organization with dedicated professionals who are passionate and committed to the service of its clients.

    Responsibilities

    Position Duties and Responsibilities:

    • Progressively achieve high level expertise with dental commercial insurance and dental Medicaid plans in which ACI affiliated practices participate within 6 months.  Act as synergistic liaison with plan representatives.
    • Explain and eventually author plan administrative tools (quick reference guides, checklists, etc.); training modules and the Dentrix system which is required for proficient practice administration.  Topics covered to include plan policy and coverage as well as general insurance administration.
    • Keep abreast of all policy and coverage changes; Dentrix and technological interfaces; and update all materials as required.
    • Conduct plan and general insurance training as well as Dentrix training to ACI affiliated practice staff.
    • Achieve high level knowledge of Dentrix and all portal trainings.
    • Accurately enter fee schedules and fee updates for all plans into Dentrix.
    • Conducti data analysis on insurance claims and Medicaid utilization and articulate outcomes of analysis to affiliated practices
    • Provide on-going assistance to practice staffs in all areas of administration (technical and policy); this assistance to occur primarily via ticketing system or phone although occasionally on-site assistance may be requested.
    • Troubleshooting and resolving practice issues related to plan policy, coverage; Dentrix and technological interfaces; and administration.
    • Act as a liaison with provider relations staff; maintain on-going dialogue and foster relationships to ensure timely response and problem resolution.
    • Policy plan administration; Dentrix; and perform other administrative tasks as required.
    • Maintain log of daily tasks via ticketing system including practice calls taken and assistance provided.
    • Providing project management support to Managers, team members, and other ACI staff.
    • Cross-train and be cross-trained on all key tasks associated with tool development, training, and administration; assist others in the department as necessary.

    Qualifications

    Qualifications

    • Ability to quickly acquire knowledge regarding commercial dental insurance and dental Medicaid requirements, reimbursement rules, and the laws and regulations governing billing and collection activities.
    • Ability to interpret and effectively communicate insurance regulations.
    • Excellent verbal and written communication skills.
    • Ability to work independently and collaboratively within a team environment.
    • Ability to facilitate telephone, in-person, and/or web-based training sessions.
    • Adaptable; readily adjusts work schedule to adhere to changes in the work environment and is able to manage competing demands.
    • Experience with areas of dental or medical insurance management (eligibility, filing, AR, etc.) preferred.

     

    Education and Experience Requirements:

     

    • Healthcare reimbursement administration or support services experience strongly preferred.
    • Proficiency with Microsoft Office and/or other computer applications required.
    • Passion to solve problems and help others solve problems essential.

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