Overview

Position Summary:

The Insurance Training Manager oversees and leads the Insurance Trainer/Specialist Team at Affordable Care and is responsible for the overall effectiveness of the training delivered to the field and clinic staff. This position will report directly to the Director of Insurance Services. The manager will utilize their expertise and knowledge related to Healthcare Revenue Cycle Management and Insurance to optimize the success of Affordable Care’s affiliated clinics. They provide training and on-going assistance to practice staff and other support personnel to ensure practice level proficiency in plan administration and revenue maximization. The Insurance Training Manager serves as a Subject Matter Expert in the Insurance Services Department across multiple practice management systems, revenue cycle processes, and future insurance and Medicaid expansion within the network of affiliated practices.

Responsibilities

Position Duties and Responsibilities :

• Develops training materials and communications related to Commercial Insurance, Medicare Advantage, and Medicaid plans.

• Understands how vendors and technology work within the revenue cycle to support our practices and effectively communicates this information to the field and other corporate departments.

• Responding to insurance related questions/requests from the field teams in a quick and efficient manner, requiring keen understanding of plan policies and all revenue cycle functions. Including but not limited to: Enrollment, Eligibility &Verification, Claims Processing, Insurance and Patient Accounts Receivable processes.

• Enter fee schedules, plans and fee updates for insurance and Medicaid plans into Dentrix.

• Keep abreast of all policy and coverage changes including reimbursement rules, and the laws and regulations governing billing and collection activities.

• Ability to work independently and collaboratively within a team environment.

• Troubleshooting and resolving practice issues related to plan policy, coverage; Dentrix, Eaglesoft, and technological interfaces.

• Log all daily tasks as well as practice calls and emails taken in Sales Force.

• Trains practice staff in person or via MS Teams on all aspects of Insurance/Medicaid Administration, including eligibility verifications, treatment planning, claims submission, payment posting, and Accounts Receivable follow-up.

• Participates in corporate meetings, along with other departments, to keep abreast of important topics and projects that impact the ISD team. Serves as subject matter expert during these meetings and actively participates in conversations to inform colleagues of interdepartmental dependencies related to the team’s work, and to ascertain any further actions needed by the ISD trainers.

• Perform other duties as new opportunities arise and/or as assigned.

Qualifications

Qualifications

• Ability to interpret and effectively communicate insurance regulations.

• Excellent verbal and written communication skills.

• Ability to facilitate telephone, in-person, and/or web-based training sessions.

• Excellent problem-solving skills.

• Well organized, accurate, and thorough.

• Adaptable; readily adjusts work schedule to adhere to changes in the work environment and able to manage competing demands.

• Adept at prioritizing, planning work activities, and developing reasonable action plans.

• Proficiency in all Microsoft Office products.

Education and Experience Requirements:

• Bachelor’s degree preferred.

• Minimum ten years commercial insurance or Medicaid experience preferred; dental experience preferred.

• Experience working in a dental practice or in the dental field preferred.

Computer Skills:

• Proficiency in a Microsoft Windows environment.

• Proficiency with dental or medical software; Dentrix and Eaglesoft preferred.

Core Competencies: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position.

• High level of customer service orientation.

• Ability to assess development needs of affiliated auxiliary practice staff.

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Job ID 2024-26854

Category Other