Dental Insurance Analyst
Sky Pediatric Dentistry, New York, NY, United States
Dental Insurance Analyst
US-NY-New York
Job ID: 2025-14993 | Type: College of Dentistry (DN1032) | # of Openings: 1 | Category: Finance/Real Estate/Procurement/Grant Management | New York University
Overview
Manage claims adjudication by identifying contractual variances between posted and expected reimbursement for Article 28, Managed Care, Commercial Insurance and other payers. Analyze, audit and recover outstanding receivables. Identify trends in payments, underpayment/overpayments and denials. Work with respective departments to evaluate trends and be part of the team that works towards resolution and improvement of the revenue cycle processes. Directly manage and resolve all assigned underpayment appeals, follow‑up and payer relationships. Report to management any gross payment discrepancies by payers. Contact payer to resolve appeals and final solution to claims. Collaborate with the Director of Insurance Strategy in developing, implementing and maintaining operational standards, providing guidance and direction relating to the performance of claims adjudication process. Train staff and administrators to support their adherence to existing and future changes relative to insurance guidelines.
Key Responsibilities
Identify contractual variances between posted and expected reimbursement for various payers.
Analyze, audit and recover outstanding receivables.
Identify trends in payments, underpayment/overpayments, and denials.
Collaborate with departments to evaluate trends, resolve appeals, and improve revenue cycle processes.
Report gross payment discrepancies and resolve appeals with payer relationships.
Develop and maintain operational standards and train staff on insurance guidelines.
Qualifications
Required Education:
Bachelor’s degree.
Preferred Education:
Master’s degree in Business or Health Care Administration.
Required Experience:
3 years relevant professional experience in reviewing and auditing insurance payments and denials, recommending policies and systems, and staff training or an equivalent combination of education and experience.
Required Skills, Knowledge and Abilities:
Knowledge of managed care guidelines and claim guidelines, ability to identify trends/issues with denials and claims payments, excellent analytical, communication and negotiation skills.
In compliance with NYC’s Pay Transparency Act, the annual base salary range for this position is USD $71,438.94 to USD $87,314.26.
NYU is an Equal Opportunity Employer and is committed to a policy of equal treatment and opportunity in every aspect of its recruitment and hiring process without regard to age, alienage, caregiver status, childbirth, citizenship status, color, creed, disability, domestic violence victim status, ethnicity, familial status, gender and/or gender identity or expression, marital status, military status, national origin, parental status, partnership status, predisposing genetic characteristics, pregnancy, race, religion, reproductive health decision making, sex, sexual orientation, unemployment status, veteran status, or any other legally protected basis. All interested persons are encouraged to apply at all levels.
#J-18808-Ljbffr
US-NY-New York
Job ID: 2025-14993 | Type: College of Dentistry (DN1032) | # of Openings: 1 | Category: Finance/Real Estate/Procurement/Grant Management | New York University
Overview
Manage claims adjudication by identifying contractual variances between posted and expected reimbursement for Article 28, Managed Care, Commercial Insurance and other payers. Analyze, audit and recover outstanding receivables. Identify trends in payments, underpayment/overpayments and denials. Work with respective departments to evaluate trends and be part of the team that works towards resolution and improvement of the revenue cycle processes. Directly manage and resolve all assigned underpayment appeals, follow‑up and payer relationships. Report to management any gross payment discrepancies by payers. Contact payer to resolve appeals and final solution to claims. Collaborate with the Director of Insurance Strategy in developing, implementing and maintaining operational standards, providing guidance and direction relating to the performance of claims adjudication process. Train staff and administrators to support their adherence to existing and future changes relative to insurance guidelines.
Key Responsibilities
Identify contractual variances between posted and expected reimbursement for various payers.
Analyze, audit and recover outstanding receivables.
Identify trends in payments, underpayment/overpayments, and denials.
Collaborate with departments to evaluate trends, resolve appeals, and improve revenue cycle processes.
Report gross payment discrepancies and resolve appeals with payer relationships.
Develop and maintain operational standards and train staff on insurance guidelines.
Qualifications
Required Education:
Bachelor’s degree.
Preferred Education:
Master’s degree in Business or Health Care Administration.
Required Experience:
3 years relevant professional experience in reviewing and auditing insurance payments and denials, recommending policies and systems, and staff training or an equivalent combination of education and experience.
Required Skills, Knowledge and Abilities:
Knowledge of managed care guidelines and claim guidelines, ability to identify trends/issues with denials and claims payments, excellent analytical, communication and negotiation skills.
In compliance with NYC’s Pay Transparency Act, the annual base salary range for this position is USD $71,438.94 to USD $87,314.26.
NYU is an Equal Opportunity Employer and is committed to a policy of equal treatment and opportunity in every aspect of its recruitment and hiring process without regard to age, alienage, caregiver status, childbirth, citizenship status, color, creed, disability, domestic violence victim status, ethnicity, familial status, gender and/or gender identity or expression, marital status, military status, national origin, parental status, partnership status, predisposing genetic characteristics, pregnancy, race, religion, reproductive health decision making, sex, sexual orientation, unemployment status, veteran status, or any other legally protected basis. All interested persons are encouraged to apply at all levels.
#J-18808-Ljbffr