American Dental Association

Manager Dental Benefits and Third-Party Payer Issues

American Dental Association • $75K — $95K *
Chicago, IL 60629In-Person
Healthcare
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience
  • 5 years in the dental industry (or 9 years without a degree)
  • 3 years of program management or operations experience
  • Experience working with external organizations or payers
  • Deep knowledge of dental benefits administration and claim adjudication processes
  • Familiarity with provider contracting and utilization management
  • Excellent communication and analytical skills

Responsibilities

  • Lead operational initiatives for the ADA's Council on Dental Benefit Programs
  • Oversee policy development and stakeholder engagement
  • Support public and professional volunteer committees
  • Manage member service functions related to the Third-Party Payer Concierge Service
  • Drive resolution of third-party payer issues through engagement with organizations
  • Facilitate committee meetings and present findings to stakeholders
  • Develop reports and documentation as necessary for program operations

Benefits

  • Promotes Work/Life Balance
  • Hybrid Work Schedule (2-3 days from home)
  • Health insurance/dental reimbursement plan
  • Ample Paid time off
  • 401(k) option
  • Flexible Spending Account
  • Life insurance coverage
  • Tuition reimbursement opportunities
  • Paid Parental Leave
  • Pet Insurance available
  • Student Loan Refinance assistance
  • 2 days off for charity work
Full Job Description
Job Responsibilities:

The Manager of Dental Benefits and Third-Party Payer Issues provides operational leadership for the ADA's Council on Dental Benefit Programs. The role oversees all aspects of the Association's dental benefits and third-party payer initiatives, including Council and program operations, policy development, and stakeholder engagement. It provides staff support for public and professional volunteer committees and oversees third-tier member service functions related to the Third-Party Payer Concierge Service.

Must Have:
  • Bachelor's degree or experience in lieu of degree
  • 5 years of experience (or 9 years in lieu of a degree) in the dental industry
  • 3 years of program management or operations
  • Experience engaging with external organizations or payers to resolve issues
  • Experience in healthcare, managed care, or insurance industry including direct experience in dental benefits administration
  • Comprehensive understanding of dental benefit plan design, administration, and reimbursement methodologies
  • Knowledge of claim adjudication processes, coordination of benefits, down coding, bundling, and non-covered services policies
  • Familiarity with provider network contracting, fee schedules, utilization management, and prior authorization practices
  • Must have verbal communication, writing, analytical, facilitation, collaboration, presentation, a self-starter, results-focused skills
  • Proficiency in M365 (MS Office)
  • Travel twice per year, 1-3 nights per trip for attendance at CDBP or ADA meetings, industry conferences/events such as AADC, or other meetings as assigned
  • Position may require before or after hours work and/or may require weekend work

Nice to Have:
  • American Association of Dental Consultants (AADC) Certification or Dental Coding or Reimbursement Certification (e.g. Dental Coding Consultant or Dental Benefit Specialist)
  • Certification in health or dental benefits administration, such as Certified Employee Benefit Specialist (CEBS), Health Insurance Associate (HIA)

Just a few of the benefits offered to employees:
  • Promotes Work/Life Balance
  • Hybrid Work Schedule (2-3 days from home)
  • Health insurance/ dental reimbursement plan
  • Ample Paid time off
  • 401(k)
  • Flexible Spending Account
  • Life insurance
  • Tuition reimbursement
  • Paid Parental Leave
  • Pet Insurance
  • Student Loan Refinance
  • 2 days off to work at a charity event of your choice

About American Dental Association

The American Dental Association (ADA) is a professional association for dentists in the United States. The organization was founded in 1859 and is based in Chicago, Illinois. The ADA has over 163,000 members, making it the largest dental association in the world. The organization's mission is to promote oral health and advance the dental profession through education, research, and advocacy. The ADA is also responsible for developing and maintaining the standards for dental education and practice in the United States.
Learn more about American Dental Association
Size
500 employees
Industry
Healthcare
* Ladders Estimates

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