DentaQuest

  • Sisters, OR 97759, USA
Aug 02, 2022
DentaQuest Austin, TX, United States
This listing is for any Board Certified Specialists (OMFS, Orthodontist, Endodontist, Periodontist or Prosthodontist).   The Dental Consultant reviews claims based on medical necessity, in accordance with market contracts, evaluate appeals, counsel providers, identify providers with aberrant utilization patterns, provide clinical support for provider outreach, and act as a clinical SME (or liaison) for internal entities. PRIMARY JOB RESPONSIBILITIES: Authorize or deny claims based on medical necessity and eligibility, in accordance to contract language after clinical review enters claim status into the system. Evaluate appeals and determine if proper documentation has been obtained to deny claim. Make further recommendations, request additional information, review charts, and make revised or reiterate claim decision. Review authorization requests for anesthesia and rendering decision on medical necessity. Review and render decisions on all orthodontic claims for handicapping...
Aug 01, 2022
DentaQuest Work From Home, United States
Under limited supervision, the Accounts Payable Coordinator supports the Finance Department and the organization by processing, recording and reporting cash disbursements. Ensures all departmental and corporate policies and procedures are followed and meet compliance & audit guidelines. Coordinator supports all new project implementations and system upgrades.   **Individual must be willing to go onsite in the Milwaukee or Boston area 2-3 days a week.    PRIMARY JOB RESPONSIBILITIES: Follows all accounts payable practices while maintaining department efficiencies, by verifying accuracy, control and meeting deadlines for scheduled weekly check runs. Ensures user documents are updated and accurate for training and compliance. Supports the daily/weekly claim processing interfaces to the oracle financial system, and ensure the daily deadlines are met for all EFT and Positive pay files.Provides daily AP payment report to AR team for Positive pay reconciliation and ensures all files...
Aug 01, 2022
DentaQuest Shreveport, LA, United States
The Provider Partner is the primary on site point person for providers to improve their understanding of our benefit programs, policies and procedures. The Provider Partner is responsible for provider networks with regard to office education, technology promotion, network recruitment (expansion and strengthening utilization), and onboarding of newly contracted providers. The Provider Partner is also responsible for administering on-site office reviews as required by network rules and regulations.    **Individual must be located in the Northwest Louisiana area. Travel reimbursement is offered for this role when needing to travel to provider offices.    Analyze and monitor provider cost reports on an ongoing basis in order to educate and improve providers’ costand quality performance. Maintain network participation by providing support to dentists and dental office managers to improve theirunderstanding of all available benefit programs. Educate providers by instructing and advising...
Aug 01, 2022
DentaQuest Work From Home, United States
Claim Payment Technical Analyst specializes in DentaQuest's payment data and process to ensure that multiple claim cycles run accurately, on time and are analyzed for financial accuracy, while providing technical support and participating in solving business problems.  The analyst understands the nuances within payment runs and report regularly on various aspects of the payment process and payment data -- such as running pre-payment review, verification that payment has been sent, retention totals and other relevant scenarios important to the daily business of DentaQuest.  The analyst exhibits the highest level of knowledge of claim system payment data, advises and tracks interest and retention complexities and assist in the reconciliation of claims system to DentaQuest's financial system. This role requires excellent communication, technical and project management skills, and must understand basic principles of accounting, writing SQL queries and data management. PRIMARY JOB...
Aug 01, 2022
DentaQuest Work From Home, United States
Job Summary Responsible for recruiting and developing broker relationships nationally for the individual dental products using telephone and web conference techniques. Responsible for meeting individual dental product sales goals and objectives through brokers. Primary Job Responsibilities Targeting strategy optimizing opportunities by product design and geography for sales success. Develops sales activity by recruiting new and further developing established broker relationships. Delivers sales presentations to brokers by web conference techniques. Optimizes closing opportunities by utilizing sales tools and previously developed professional skills. Ensures accurate documentation of leads and sales received from all sources. Collects competitive intelligence and shares with management. Recommends the most effective means of solving issues. Assists in sales forecasting activities and setting performance goals. Works in matrix environment and establishes positive internal...
Aug 01, 2022
DentaQuest Macon County, GA, United States
The Provider Partner is the primary on site point person for providers to improve their understanding of our benefit programs, policies and procedures. The Provider Partner is responsible for provider networks with regard to office education, technology promotion, network recruitment (expansion and strengthening utilization), and onboarding of newly contracted providers. The Provider Partner is also responsible for administering on-site office reviews as required by network rules and regulations.     **Individual must be located in the Southwest Georgia area. Travel reimbursement is offered for this role when needing to travel to provider offices.  Analyze and monitor provider cost reports on an ongoing basis in order to educate and improve providers’ cost and quality performance. Maintain network participation by providing support to dentists and dental office managers to improve their understanding of all available benefit programs. Educate providers by instructing and advising...
Aug 01, 2022
DentaQuest Work From Home, United States
The Payment Reconciliation Analyst is primarily responsible for the operational execution of 820 payment file reconciliation against member level billing. This includes processing data files, research and analysis of discrepancies, and systemic delivery of output to internal and external clients. Works with stakeholders to identify root cause and resolution of billing and payment discrepancies through professional interaction with appropriate external client contacts and other internal organizations. Handles clients' 820 implementation onboarding, from onset to post implementation monthly processing.   **Individual must be located in the EST and CST time zone.    Primary Job Responsibilities Manages new client 820 implementations, including onboarding of 820 receipt, gathering client requirements, testing, processing and providing required output throughout New Business Implementation project, and continue with monthly reporting per contract requirements upon implementation....
Aug 01, 2022
DentaQuest Boston, MA, United States
Key position within the finance department.  Reviews, analyzes, reconciles and researches activity related to all corporate bank accounts.  This position serves as a liaison between the finance department and financial institutions for questions regarding debits, credits and charges to corporate accounts.   **Individual must be willing to go onsite to the Charlestown, MA office 3-4 days a week.    PRIMARY JOB RESPONSIBILITIES:  Performs daily and monthly cash reconciliations for all corporate accounts ensuring that bank batch totals match daily cash receipts recorded in the Oracle Accounts Receivable system. Resolves cash issues in a timely manner by recording and following up on reconciling items. Functions as a point of contact for banking activities with the ability to research and resolve moderately complex questions and issues. Effectively communicates with internal and external contacts. Ensure timely and accurate close process for cash. Process stop payment and void check...
Aug 01, 2022
DentaQuest Milwaukee, WI, United States
Responsible for creating insights from operational and clinical data collected from core processing system and other databases, applying analytic methodologies and products and developing dashboards and other forms of knowledge sharing to optimize benefit administration. Centralize operational data and report on key performance indicators, utilization and performance metrics and operational costs using predictive and analytic models. Provide analysis and trending of operational and financial results to support leadership decisions related to expense management, staffing, workflow design and process improvement.  Develop and maintain a code library and operational data that optimizes modeling and predictive analytics.  Works with other areas, including the client and provider engagement and business intelligence functions to optimize the use of analytics in Operations. PRIMARY JOB RESPONSIBILITIES: Create and maintain reporting package for operational areas relevant to cost...
Apr 27, 2021
DentaQuest Milwaukee, WI, USA
Remote Opportunity: 1Requisition Number: 3576Position Title: Developer, LeadExternal Description:POSITION SUMMARY:Creates, modifies and maintains application programs in response to the changing needs of DCPG. Works with end users to achieve optimal results toward completion of each project.ESSENTIAL JOB FUNCTIONS:Under general direction:Coding, testing and debugging programs according to requirement specifications.Modifying, expanding and updating applications.Diagnosing and fixing bugs found by end users.Developing software prototypes.Communications with a team that includes analysts, engineers and quality assurance testers in order to coordinate and document application development and testing.Acting as a technical mentor and advisor for the development team.Providing creative vision and managing the planning and implementation of web-based applications.Overseeing application coding and providing technical expertise and mentoring other developers.Performs other duties as...