Payer Relations Specialist

Rallyday Partners; California; On-site; USD 90,000 - 120,000; Full time

Job summary

Rallyday Partners seeks a payer relations professional to manage day-to-day interactions with dental insurers and payers in California. You will lead communications, maintain contact data, and represent the company in meetings and reviews, driving clear ownership and issue resolution.

In this role, you will review contracts, fees, and reimbursement terms, prepare analyses for renewals, and collaborate with Revenue Cycle, Finance, Operations, and Legal teams to optimize payer relationships and

Qualifications

• Bachelor's degree in business, healthcare administration, finance, or a related field.
• At least three years of experience in dental or healthcare payer relations, managed care contracting, revenue cycle management, or a related discipline.
• Working knowledge of dental insurance, payer contracts, fee schedules, claims processing, denials, credentialing, and provider network participation.
• Experience interpreting contract language and translating reimbursement terms into operational and financial implications.
• Intermediate to advanced Microsoft Excel skills; experience with dental practice-management, revenue-cycle, contract-management, or business-intelligence systems preferred.
• Strong written and verbal communication skills with the ability to work effectively with payer representatives and internal leaders.

Responsibilities

• Serve as the primary day-to-day contact for assigned dental insurance carriers, third-party administrators, and payer representatives.
• Build productive relationships with payer contacts to improve communication, accountability, and issue resolution.
• Maintain current payer contact information, escalation pathways, meeting notes, commitments, and follow-up items.
• Represent Espire professionally in payer meetings, business reviews, and issue-resolution discussions.
• Support the review of payer agreements, amendments, participation requirements, reimbursement terms, and fee schedules.
• Prepare analyses and supporting materials for contract discussions, renewals, and negotiation strategy.
• Identify material contract terms, operational requirements, risks, and opportunities for review by Revenue Cycle, Finance, Operations, and leadership.
• Maintain an organized contract inventory and track renewal dates, notice periods, rate changes, and outstanding payer commitments.
• Support network participation assessments using reimbursement, access, operational impact, and strategic fit.
• Collaborate with Revenue Cycle, Credentialing, Operations, Finance, Legal, Procurement, and Practice teams on payer-related priorities.
• Provide payer guidance and timely updates to internal stakeholders while maintaining clear ownership boundaries.
• Identify workflow or documentation changes that may reduce avoidable denials and improve reimbursement accuracy.
• Support training and communication related to payer changes, contract requirements, and recurring reimbursement issues.
• Perform other duties and special projects as assigned by the Revenue Cycle Manager.

Skills

Communication skills

Relationship building

Multi-tasking

Attention to detail

Contract interpretation

Education

Bachelor's degree in business/healthcare administration/finance

3+ years in dental/healthcare payer relations

Tools

Microsoft Excel

Job description

Education Level4 Year Degree* Serve as the primary day-to-day contact for assigned dental insurance carriers, third-party administrators, and payer representatives.* Build productive relationships with payer contacts to improve communication, accountability, and issue resolution.* Maintain current payer contact information, escalation pathways, meeting notes, commitments, and follow-up items.* Represent Espire professionally in payer meetings, business reviews, and issue-resolution discussions.* Support the review of payer agreements, amendments, participation requirements, reimbursement terms, and fee schedules.* Prepare analyses and supporting materials for contract discussions, renewals, and negotiation strategy.* Identify material contract terms, operational requirements, risks, and opportunities for review by Revenue Cycle, Finance, Operations, and leadership.* Maintain an organized contract inventory and track renewal dates, notice periods, rate changes, and outstanding payer commitments.* Support network participation assessments using reimbursement, access, operational impact, and strategic fit.* Collaborate with Revenue Cycle, Credentialing, Operations, Finance, Legal, Procurement, and Practice teams on payer-related priorities.* Provide payer guidance and timely updates to internal stakeholders while maintaining clear ownership boundaries.* Identify workflow or documentation changes that may reduce avoidable denials and improve reimbursement accuracy.* Support training and communication related to payer changes, contract requirements, and recurring reimbursement issues.* Perform other duties and special projects as assigned by the Revenue Cycle Manager.* Bachelor's degree in business, healthcare administration, finance, or a related field preferred; relevant experience may substitute for formal education.* At least three years of experience in dental or healthcare payer relations, managed care contracting, revenue cycle management, reimbursement analysis, or a related discipline preferred.* Working knowledge of dental insurance, payer contracts, fee schedules, claims processing, denials, credentialing, and provider network participation.* Experience interpreting contract language and translating reimbursement terms into operational and financial implications.* Intermediate to advanced Microsoft Excel skills; experience with dental practice-management, revenue-cycle, contract-management, or business-intelligence systems preferred.* Strong written and verbal communication skills with the ability to work effectively with payer representatives and internal leaders.* Ability to manage multiple priorities, protect confidential information, and close the loop on time-sensitive commitments.