Insurance Claims Pacesetter

At Risas Dental and Braces, our focus is providing quality and affordable dental care and braces for families everywhere. Unlike many healthcare options, our goal is to think and speak a language that patients understand. For this reason, our Company Statement is We Speak Patient™. The result is happier, healthier Patients, and better opportunities for our doctors and team members.

Summary

We are searching for a dynamic leader to join our Risas Family as an Insurance Claims Manager. The Manager will lead collaborative efforts in crafting and implementing policy and procedures, analyzing metrics, and developing strategies to improve operational efficiencies. The Insurance Claims manager will also establish and maintain collaborative communication with providers externally and departments within the organization internally to ensure adherence to improvement and workflow strategies. The manager will additionally focus on mentoring, training, and developing staff to a high quality of exceptional service and performance.

Responsibilities

• Provide leadership for a team, specifically hiring, motivating, training, monitoring, and reporting productivity.
• Must be a phenomenal communicator, able to effectively set expectations, performance goals, and provide ongoing feedback to employees and leadership to share successes and improvement opportunities.
• Handle client and internal KPI’s, make recommendations, implement improved performance, and process opportunities.
• Capable of researching, assisting, and ensuring teammates are timely with cross-functional communication, tracing, and coding, submitting appeals and correcting any errors where necessary.
• Perform a review and audit of high-volume offices on a regular basis to ensure proper actions are being taken for maximum reimbursement.
• Assign workloads to teammates and monitor results and workflow.
• Maintain professional partnerships with insurance carriers/providers.
• Run performance and departmental reports as needed.

Qualifications

• High School Diploma or GED
• Bilingual English/Spanish preferred
• Proven understanding of Dental Explanation of Benefits (EOB), ADA forms, and insurance billing process
• Experience with medical billing, dental billing, payment posting and insurance tracing
• Strong professional and interpersonal communications skills verbally and through written correspondence.
• Advanced analytical skills to analyze problems, to apply data and information to solve administrative and/or operating problems and provide the appropriate solution.
• Strong conflict resolution skills; advanced problem solving, multi-tasking and organizational skills with strong attention to detail.
• Must be highly confidential to protect the client’s privacy rights; proven ability to prioritize workflow during high volumes and within critical time frames.
• Proven leadership/management skills to motivate, mentor, train, coach, evaluate performance and lead a team in a fast-paced, dynamic environment

Risas Dental and Braces offers a comprehensive benefits package, health, and wellness benefits with FREE dental and braces services, 401(k) with employer match, and many other ancillary benefits. Risas is an equal opportunity employer and values diversity at our company. The working environment is fun, dynamic, challenging, and rewarding with opportunities for professional development and career advancement. Join us in this work. Begin a career that is full of meaning and value.