Insurance Contract Specialist

SGA Dental Partners•Claxton, GA

4d•Onsite

About The Position

SGA Dental Partners is hiring for an Insurance Contract Specialist in Claxton, GA. The Insurance Contract Specialist supports the development and execution of payer strategies to optimize reimbursement and improve financial performance across dental practices. This role focuses on analyzing payer data, maintaining fee schedules and contracts, and collaborating with internal teams and payer partners to ensure accurate implementation, compliance, and operational efficiency.

Requirements

Knowledge of English composition, grammar, spelling and punctuation.
Skilled in the use of basic office equipment such as telephones, calculators, copier, fax, computers and computer software (MS Excel, Word, Practice Management software).
Proficient in Microsoft Excel & Powerpoint
Ability to be professional and maintain composure when dealing with stressful situations.
Ability to cooperatively work with the doctors, co-workers, various facilities, and patients and build relationships of trust.
Maintain confidence with the patient regarding doctors and staff.
Ability to prioritize, organize and complete tasks timely.
Ability to accept constructive criticism.
Ability to understand and follow written and verbal instructions.
Ability to collect data, establish facts and maintain confidentiality.
Ability to communicate and express thoughts and ideas clearly and competently.
Ability to quickly grasp relevant concepts regarding duties and responsibilities.
Treat patients, co-workers, and doctors professionally and courteously.
Associate Degree preferred
5+ years of medical/dental credentialing experience ideal
Strong understanding of insurance payor processes, credentialing standards, and provider data management preferred.

Responsibilities

Support the development and execution of payer strategies to optimize reimbursement and improve financial performance
Maintain and support relationships with payer partners, assisting with contract negotiations and ongoing collaboration
Monitor and manage payer contracts and fee schedules, identifying discrepancies and supporting updates or renegotiations
Assist in conducting market and payer analysis to identify trends, risks, and opportunities
Perform UCR and payer mix analyses to support network optimization and practice performance
Maintain and update UCR fee schedules, including management of master fee schedule documentation
Analyze data to evaluate payer contract performance and identify areas for improvement
Prepare and distribute regular reports on payer performance and key operational metrics
Ensure accuracy and completeness of payer data, contract terms, and reporting across systems
Support compliance with regulations, payer requirements, and internal policies
Collaborate with internal teams (finance, operations, clinical, revenue cycle) to support payer-related initiatives and workflow improvements
Communicate with practices regarding payer updates, contract changes, and implementation activities
Assist with implementation of new contracts and fee schedules across practices
Support process improvement initiatives to enhance efficiency and data accuracy
Stay informed on industry trends, payer updates, and regulatory changes
Maintain confidentiality and adhere to documentation and compliance standards
Perform additional administrative or operational duties as assigned