Manager Dental Benefits and Third-Party Payer Issues
Job Responsibilities
The Manager of Dental Benefits and Third-Party Payer Issues provides operational leadership for the ADA’s Council on Dental Benefit Programs. The role oversees all aspects of the Association’s dental benefits and third-party payer initiatives, including Council and program operations, policy development, and stakeholder engagement. It provides staff support for public and professional volunteer committees and oversees third-tier member service functions related to the Third-Party Payer Concierge Service.
Must Have
- Bachelor's degree or experience in lieu of degree
- 5 years of experience (or 9 years in lieu of a degree) in the dental industry
- 3 years of program management or operations
- Experience engaging with external organizations or payers to resolve issues
- Experience in healthcare, managed care, or insurance industry including direct experience in dental benefits administration
- Comprehensive understanding of dental benefit plan design, administration, and reimbursement methodologies
- Knowledge of claim adjudication processes, coordination of benefits, down coding, bundling, and non-covered services policies
- Familiarity with provider network contracting, fee schedules, utilization management, and prior authorization practices
- Versatile communication, writing, analytical, facilitation, collaboration, presentation, a self-starter, results-focused skills
- Proficiency in M365 (MS Office)
Nice to Have
- American Association of Dental Consultants (AADC) Certification or Dental Coding or Reimbursement Certification (e.g. Dental Coding Consultant or Dental Benefit Specialist)
- Certification in health or dental benefits administration, such as Certified Employee Benefit Specialist (CEBS), Health Insurance Associate (HIA)
Benefits
- Promotes Work/Life Balance
- Hybrid Work Schedule (2-3 days from home)
- Health insurance/dental reimbursement plan
- Ambitious Paid time off
- 401(k)
- Flexible Spending Account
- Life insurance
- Tuition reimbursement
- Paid Parental Leave
- Pet Insurance
- Student Loan Refinance
- 2 days off to work at a charity event of your choice
About the Role
The ADA’s headquarters is located just steps from Chicago’s Magnificent Mile and close to public transportation. With more than 400 colleagues, the ADA Staff are some of the most talented people in the Chicago, Washington D.C., and Maryland area. We were named a Top Workplace by the Chicago Tribune in 2019 and 2021!
Qualifications
None specified
Skills
None specified
Pay
Not specified
Schedule
Not specified