Dental Insurance Analyst

Claims Adjudication Manager

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 maintain 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.

Qualifications

Required Education:

Bachelor's degree

Preferred Education:

Master's degree in Business or Health Care Administration

Required Experience:

3 years' relevant professional experience including 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 guidelines of managed care and claims guidelines and ability to identify trends/issues with denials and claims payments. Excellent analytical, communication and negotiation skills.

Additional Information

In compliance with NYC's Pay Transparency Act, the annual base salary range for this position is USD $71,610.75 to USD $87,524.25. New York University considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and organizational considerations when extending an offer. This pay range represents base pay only and excludes any additional items such as incentives, bonuses, clinical compensation, or other items. NYU aims to be among the greenest urban campuses in the country and carbon neutral by 2040. Learn more at NYUGREEN. 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.