Insurance Services Manager

Essential Functions

• Manage and support operations related to the evaluation, processing, and handling of claims; assure that departmental, federal, and state specific standards are maintained and that claims are handled accurately and timely; plan future courses of action and management of the overall insurance/posting activities to ensure effective and efficient operations.
• Manage accuracy and keep up to date all insurance set-up information in AxiUm and Dolphin applications including but not limited to insurance companies, benefit plans, coverage templates, contract plans, billing provider information.
• Ensure accurate posting of all charges and patient payments daily; review/advise on accuracy and completeness of procedure codes, fee schedules and treatment notes.
• Review, monitor, and analyze claim activity reports for the Revenue cycle staff to include claim submission, production, billing, and accounts receivable; ensure insurance billers are monitoring and managing claim productivity.
• Reconcile and resolve financial issues with patients and resolve insurance grievances between insurance companies and patients.
• In collaboration with the DPFRC, develop and manage business policy/procedures for clinic operations; provide the Business Office with reports and reconciliations as necessary.
• In collaboration with the DPFRC, manage all contracts and communications with Delta and any other approved contract providers; ensure timely annual filing of fees; create and maintain current documentation regarding policies for processing, billing, and collecting insurance.
• Set daily expectations; monitor performance to ensure that staff are meeting and/or exceeding established performance goals (production and quality).
• Oversee and manage clinic finance liaison, group practice patient care and insurance coordinators as part of the financial team to achieve optimal revenue capture through best practices and efficient forward-thinking use of technology and resources.
• Support the DPFRC and Clinical Financial Operations Manager to train students, faculty, and staff on proper protocols and procedures related to insurance.
• Act as a liaison between the School of Dentistry, insurance providers, and patients regarding status and eligibility for coverage; manage and resolve patient billing inquiries.
• Provide monthly summary reports to the Business Office; review clinic production and expenses; advise and make recommendations to ensure achievement of budget goals.
• Actively seek out and drive process improvement, automation, and cost-efficient initiatives related to clinic business activities.

Minimum Qualifications

• Knowledge of: Dental practice management. Dental/Medical insurance credentialing.
• Demonstrated ability to manage time effectively, balance multiple priorities, and drive tasks and projects to successful completion.
• Prominent track record of navigating complex and urgent issues with clarity and efficiency.
• Thorough knowledge of the practices, procedures, and core concepts within the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• Dental terminology/treatment and insurance procedures.
• Electronic dental billing systems.
• Accounting/billing procedures.
• Principles of management and supervision.
• Principles of business communication, including interpersonal interactions and letter and report writing.
• Microsoft Excel, Word, and Access.
• Ability to: Communicate effectively with a diverse population of patients, students, staff, faculty and administration.
• Produce professional and concise reports and written correspondence.
• Analyze financial reports and make appropriate recommendations.
• Ability to meet benchmarks in a fast-pace high-volume setting.
• Work independently with minimal supervision.
• Provide effective leadership, training, and supervision.
• Maintain confidentiality of information.
• Manage multiple projects and consistently meet deadlines.
• Experience: Minimum of five years dental insurance claims processing experience. Minimum five years increasingly responsible management experience, preferably in a dental or medical office. Minimum 5 years experience in Revenue Cycle Management.
• Education: Bachelor’s degree in related field.

Working Conditions

• Position is full-time, 8 hours per day, 5 days per week.