DSO Insurance Fee Negotiation Manager

Remote, USA Full-time
DSO INSURANCE FEE NEGOTIATION MANAGER Department: Insurance Location: Remote Employment Type: Full-Time Company: DSO Structured Organization Industry: Dental ABOUT THE ROLE We are seeking an experienced, relationship-driven DSO Insurance Fee Negotiation Manager to lead our organization’s dental insurance partnership strategy. This role is responsible for strengthening carrier relationships, driving profitable contract negotiations, managing provider support escalations, and optimizing practice-level PPO performance. The ideal candidate brings a blend of payor fee negotiating expertise, analytical skills, and hands-on experience supporting dental practices with PPO planning, reimbursement, credentialing, and support. This is a high-visibility position that works cross-functionally with internal teams and directly with dental practices and external carrier partners. _______ KEY RESPONSIBILITIES Insurance Relationship Management & Network Expansion • Maintain, strengthen, and expand relationships with key dental insurance carriers. • Serve as the primary representative in negotiations, escalations, and strategies. • Identify and contract with new carriers that enhance network access with enhanced fee schedules. Fee Negotiation & Fee Schedule Analysis • Lead all negotiation cycles, including upgrades, amendments, and new agreement discussions. • Perform detailed analysis of fee schedules and reimbursement models to drive profitable outcomes for our providers. PPO Mix Optimization (Mapping) • Meet with dental practices to assess their contracted carrier mix, fees, and insurance goals. • Provide expert PPO mapping recommendations to optimize profitability, efficiency, and practice goals. • Provide all needed information to guide practices through participation decisions. Practice Support for Insurance & Credentialing Issues • Serve as a key resource for dental practices facing carrier-related challenges. • Assist practices in resolving credentialing and enrollment obstacles that impact reimbursement or claim acceptance. • Guide office managers and staff through carrier portal navigation, claims and EOB reviews, documentation requirements, and proper submission workflows. • Provide clear, actionable support to help practices prevent recurring issues, reduce delays, and maintain clean claim submission. • Strengthen practice-level understanding of payor expectations, improving overall accuracy and efficiency in insurance interactions. RCM Development & Cross-Functional Collaboration • Contribute subject matter expertise to help design and launch a dental Revenue Cycle Management (RCM) service. _____ QUALIFICATIONS 5+ years in dental insurance contracting/credentialing. 5+ years of insurance relationship management. 5+ years in insurance fee negotiations on behalf of large DSO groups. Strong understanding of PPO reimbursement, fee schedules, and claim workflows. Full understanding of CDT codes, downcoding, cross-coding, carrier networks, TPA’s/leasing networks/umbrella groups, and PPO plans. Deep understanding of mapping, stacking, EOB’s, and network leasing and relationships. Skilled negotiator with strong analytical and communication abilities. Dental industry experience is required. Experience with dental practices or DSOs preferred. ____ COMPENSATION Full-time Remote Salary: $83,000 annual Performance bonusses available 401K and company match Health insurance and/or HSA contributions Life Insurance Pay: $83,000.00 per year Benefits: • 401(k) • 401(k) matching • Health insurance • Health savings account • Life insurance Application Question(s): • Years of experience fee negotiating on behalf of large DSO groups. • Years of experience in DENTAL provider credentialing. • Years of experience in Insurance (Carrier) relationship management. Work Location: Remote Apply tot his job
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