Insurance Contract Specialist

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

The Insurance Contract Specialist supports the development and execution of payer strategies to optimize reimbursement and improve financial performance across dental practices. This role focuses on analyzing payer data, maintaining fee schedules and contracts, and collaborating with internal teams and payer partners to ensure accurate implementation, compliance, and operational efficiency.

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:

Associate Degree preferred

5+ years of medical/dental credentialing experience ideal

Strong understanding of insurance payor processes, credentialing standards, and provider data management preferred.

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. Apply today to join us in making a difference!

In order to maintain a high level of clinical excellence, SGA Dental Partners and dental practices affiliated with SGA maintain a drug free and alcohol free workplace. All new hires are required to pass a full panel drug screening as a condition of employment.