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Director of Insurance Fee Maximization

41 N Rio Grande St, Salt Lake City, UT
Full-time
Salary: $55,000.00 /year


Position– Director of Insurance Fee Maximization

Location– Salt Lake City, Utah

Our Company
The Dental Cooperative is a collective of independent dentists, about 600 strong. We were established in 1998, and have been working to keep independent dentists strong within a changing dental industry. The Cooperative is the oldest operating Cooperative of independent dentists in the nation. We are headquartered in Salt Lake City, Utah. Learn more about us at www.dentalcooperative.com.

It’s nice to work at a place with a purpose. Our mission is to “Empower and Preserve Independent Dentistry” by providing a platform for independent dentists to organize and unite as a large group. Through the Cooperative, members maintain their independence as practitioners and private business owners while having access to benefits that large corporate practices enjoy.

What We Do

Cooperative members have access to a variety of programs and services managed by the Dental Cooperative including: Group Purchasing Programs, Patient Dental Programs, Dental Insurance Fee Maximization, HR Services and Group Health Insurance, Practice Financing, Practice Transitioning, Merchant Services, and more. Our job is to help our members get the most out of their Cooperative membership and the most out of their participating programs.

Position Description

The Director of Insurance Maximization position is the lead specialist in the Cooperative that interfaces with both our dentist members and our dental insurance partners. Our existing Fee Maximization program helps our dentists find and enroll with profitable fee schedules offered from our payor partners.

Your primary responsibilities will include processing insurance documents received from our Dental Cooperative practices and managing the credentialing and upgrade request process with various insurance carriers. Educating member practices on how insurance networks are designed and the optimal ways to maximize participation and compensation within PPO plans is a critical part of this position, so good communication skills are required. You will experience the appreciation from our members while helping them navigate a complex industry and process.

The Director will help us improve the existing process to provide a better member experience and enable growth for the company within this service. We will look to this position to help guide us to future opportunities with our practices and insurance carriers.

Who We Are Looking For

We want to get the right person in the right position so they can have success and feel empowered. Our team is small and close, so we need people who can work together well and problem solve in an effective way. Here are a few key characteristics we look for:

  • Good Communication – Verbal and written. Express yourself clearly and concisely.
  • Good Listening – Listen to others and use constructive criticism for the good of yourself and company.
  • Good Collaboration – You will work with all the team members, so we need someone who can work well with everyone. When issues or differences of opinion arise, we need team members who can respectfully disagree but still effectively work with each other to move the company forward.
  • Willing to Learn – Everyone lacks some skills. That’s OK as long as you are willing to learn. It’s fine to ask for help and admit when you don’t know. That’s a sign of strength here.
  • A Positive Attitude – Work can be stressful, but a positive attitude make it much easier. We need people who can look for the good and let things go when needed. We want your positivity to shine to our members and team.
  • Detail Oriented – We need someone who always pays attention to the small things every time. This position is all about the small things.
  • Organized – There are a lot of moving parts and hyper organization will make it work. We expect this person to leverage the tools we have invested in to create highly structured and organized environment and process.
  • Driven but Patient – We are looking for a person who wants to do more and is looking for ways to make improvements, but can be patient with the limitation and speed of our organization.

Is this you? We hope so.

Responsibilities
The Director of Insurance Maximization is the lead for all our dental insurance maximization efforts and services. The candidate will take over our current insurance maximization efforts and responsibilities and will be a key leader in our future and expanding services all relating to dental insurance:

  • Dental Insurance Credentialing – Receive credentialing paperwork from dental practices, review and confirm accuracy prior to submission to dental carriers. Follow and improve a strict and documented internal process within our CRM and related systems. Manage the request, submission, approval and communication process back to our member practices and between participating carriers.
  • Upgrade Requests – Receive upgrade request documents and review and confirm accuracy prior to submission to dental carriers. Follow and improve a strict and documented internal process within our CRM and related systems. Manage the request, submission, approval and communication process back to our member practices and between participating carriers.
  • Provider Relations – Direct communication with our member dentists to educate and assist in all areas of the insurance maximization process. Good communication, patience, and a positive representation of the Dental Cooperative is critical.
  • Payor Relations – Maintain a strong and professional relationship with all key managers at our insurance carrier partners. Frequent and professional communication to maintain a positive relationship is critical.
  • New Payor Relations – Find new carriers for potential partnerships.
  • Fee Maximization Data – Manage fee data needed to share with insurance carrier partners and potential partners for credentialing and upgrade services.
  • Member Instruction – Manage the communication efforts back to our members on how to use our fee maximization service. This includes instructions and processes documented on our Member Services website.
  • Documentation – Create and maintain a documented process for all services related to insurance fee maximization.

Skills Needed

  • Experience (4+years) with dental insurance credentialing and billing required.
  • Must be highly proficient in Microsoft Excel.
  • Microsoft Dynamics 365 experience a plus.
  • Exceptional problem solving skills.
  • Good team and communication skills.
  • Experience in the dental industry required.
  • Previous employment with dental insurance companies a plus.
  • Highly organized and detail oriented.
  • Member escalation management skills required.

Compensation and Benefits

  • Salary ($55,000 + Bonus opportunities based on new responsibilities/skills acquired and meeting goals).
  • 90 day training & trial period
  • 1.5 accrued vacation/sick days per month + holiday

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