Insurance Contract Specialist

117090 SGA Dental Partners OPCO LLC; Claxton (GA); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Paid holidays

PTO

401(k)

Health insurance

Vision insurance

Dental insurance

Life insurance

Care.com membership

Employee Assistance Program

Disability insurance

Critical Illness insurance

Accident insurance

Job summary

SGA Dental Partners in Claxton, GA is hiring an Insurance Contract Specialist to support payer strategies, optimize reimbursement, and maintain key partner relationships.

This role involves analyzing payer data, updating fee schedules, ensuring contract terms accuracy, and collaborating with finance, operations, clinical and revenue cycle teams to drive performance and compliance.

Qualifications

• High school diploma or GED required.
• Associate degree preferred.
• Medical or dental credentialing experience.
• Experience with insurance payer processing & credentialing.

Responsibilities

• Support payer strategy development to optimize reimbursement.
• Maintain relationships with payer partners and assist in contract negotiations.
• Monitor payer contracts and fee schedules; identify discrepancies.
• Conduct market and payer analysis to spot trends and risks.
• Perform UCR and payer mix analyses to support network optimization.
• Update master fee schedules and ensure data accuracy across systems.
• Prepare reports on payer performance and key metrics.
• Ensure regulatory and internal policy compliance.
• Collaborate with finance, operations, clinical, and revenue cycle teams.

Skills

Excel proficiency

PowerPoint

Credentialing knowledge

Payer processing

Communication skills

Data confidentiality

Organization

Team collaboration

Education

High school diploma or GED

Associate degree (preferred)

Medical/Dental credentialing experience

Insurance payor processing & credentialing experience

Tools

MS Excel

PowerPoint

Practice Management software

Word

Job description

Job Summary

SGA Dental Partners is hiring for an Insurance Contract Specialist in Claxton, GA.

Schedule: Mon - Fri 8 - 5

Key Roles and Responsibilities

• Support the development and execution of payer strategies to optimize reimbursement and improve financial performance
• Maintain and support relationships with payer partners, assisting with contract negotiations and ongoing collaboration
• Monitor and manage payer contracts and fee schedules, identifying discrepancies and supporting updates or renegotiations
• Assist in conducting market and payer analysis to identify trends, risks, and opportunities
• Perform UCR and payer mix analyses to support network optimization and practice performance
• Maintain and update UCR fee schedules, including management of master fee schedule documentation
• Analyze data to evaluate payer contract performance and identify areas for improvement
• Prepare and distribute regular reports on payer performance and key operational metrics
• Ensure accuracy and completeness of payer data, contract terms, and reporting across systems
• Support compliance with regulations, payer requirements, and internal policies
• Collaborate with internal teams (finance, operations, clinical, revenue cycle) to support payer-related initiatives and workflow improvements
• Communicate with practices regarding payer updates, contract changes, and implementation activities
• Assist with implementation of new contracts and fee schedules across practices
• Support process improvement initiatives to enhance efficiency and data accuracy
• Stay informed on industry trends, payer updates, and regulatory changes
• Maintain confidentiality and adhere to documentation and compliance standards
• Perform additional administrative or operational duties as assigned

Knowledge/Skills/Abilities

• Knowledge of English composition, grammar, spelling and punctuation.
• Skilled in the use of basic office equipment such as telephones, calculators, copier, fax, computers and computer software (MS Excel, Word, Practice Management software).
• Proficient in Microsoft Excel & Powerpoint
• Ability to be professional and maintain composure when dealing with stressful situations.
• Ability to cooperatively work with the doctors, co-workers, various facilities, and patients and build relationships of trust.
• Maintain confidence with the patient regarding doctors and staff.
• Ability to prioritize, organize and complete tasks timely.
• Ability to accept constructive criticism.
• Ability to understand and follow written and verbal instructions.
• Ability to collect data, establish facts and maintain confidentiality.
• Ability to communicate and express thoughts and ideas clearly and competently.
• Ability to quickly grasp relevant concepts regarding duties and responsibilities.
• Treat patients, co-workers, and doctors professionally and courteously.

Education & Experience

• Required: High school diploma or GED
• Preferred, but not required: Associate Degree
• Medical/Dental credentialing experience
• Insurance payor processing & credentialing experience

Benefits We Offer

• Paid Holidays and Paid Time Off (PTO)
• 401(k) Retirement Plan
• Health and Vision Insurance
• Employer-Paid Dental Insurance, Life Insurance, Care.com Membership & Employee Assistance Program
• Supplemental Coverage (Disability, Critical Illness, Accident)

Career Growth and Development Opportunities

In hometown communities, SGA Dental Partners is a beacon of positive energy, delivering the highest level of clinical excellence and patient-centered care.

Drug Screening Compliance

All new hires are required to pass a full panel drug screening as a condition of employment.

Equal Opportunity Employer and Diversity

SGA Dental Partners is an Equal Opportunity Employer and values diversity at every level of our team. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Company Culture

In hometown communities across the country, SGA Dental Partners is a beacon of positive energy, making a meaningful difference in the lives of patients, team members, and the communities we serve. Built through the coming together of long respected dental practices, we are united by a shared commitment to clinical excellence, compassionate care, and a people first culture. At SGA, we believe in continuous improvement because we know that when our people grow, our care gets better. Guided by our Empower Improvement mindset and our belief that we get better every day, we invest in our teams through development, collaboration, and leadership opportunities. Whether you are early in your career or an experienced professional, you will find an environment that supports growth, recognizes contribution, and encourages innovation.