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Healthcare Insurance Relations Manager

2 months ago

Morrisville, North Carolina, United States Affordable Care Full time
Job Summary

We are seeking a highly skilled and experienced Insurance Relations Manager to join our team at Affordable Care. The successful candidate will be responsible for coordinating and communicating with our dental and health plan payers, supporting our 450 clinics and 700+ providers in managing and communicating all things insurance, claims, billing, rates, and credentialing.

Key Responsibilities
  • Vendor Management: Oversee the performance of outsourced vendors to ensure quality, cost, and timeliness of service to our practices and corporate.
  • Reporting and Analysis: Provide weekly reports of progress on key performance indicators (KPIs) and issues to management and vendors, with a focus on continually exceeding KPIs and driving efficiency.
  • Internal Coordination: Coordinate all internal department activities related to revenue cycle management (RCM) activities, which will initially be outsourced.
  • Communication and Presentation: Create presentations to share strategy, metrics, and performance with management and vendors.
  • AR Resolution: Interact with the Central Billing Office (RCM team) to handle next steps in accounts receivable (AR) resolution identified by status checks performed by outside vendors.
  • Audits and Monitoring: Conduct audits and monitoring of outsourced services to ensure efficiency and adoption by our practices.
  • Feedback and Process Improvement: Seek regular feedback relevant to outsourced functions and monitor process flows to provide feedback and improve processes and results.
Requirements
  • Insurance Expertise: Ability to interpret and effectively communicate insurance regulations.
  • Communication Skills: Excellent verbal and written communication skills.
  • Training and Facilitation: Ability to facilitate telephone, in-person, and/or web-based training sessions.
  • Problem-Solving and Organization: Excellent problem-solving skills, with the ability to prioritize, plan work activities, and develop reasonable action plans.
  • Technical Skills: Proficiency in Microsoft Office products, especially PowerPoint.
Education and Experience
  • Education: Associates degree required, bachelor's degree preferred.
  • Experience: Minimum five years commercial insurance or Medicaid experience preferred, with experience in a medical or dental practice also preferred.
Computer Skills
  • Microsoft Windows: Proficiency in a Microsoft Windows environment.
  • Dental or Medical Software: Proficiency with dental or medical software, with Dentrix preferred.