Data Review Specialist, Revenue Cycle Management

Data Review Specialist, Revenue Cycle Management

Heartland Dental is seeking a Data Review Specialist to support the vision and mission of Heartland Dental by ensuring the accuracy and integrity of our data. This role is crucial for identifying and addressing data discrepancies to improve the first-pass success of claims.

About Heartland Dental:

Heartland Dental is the nation's largest dental support organization, providing non-clinical administrative support services to more than 3,000 supported doctors across 39 states and the District of Columbia in 1,900+ dental offices. Each Heartland Dental supported office is unique to the community and the patients they serve. Supported doctors are the clinical leaders of their practice, retain full clinical autonomy, and establish their own care philosophies. All Heartland Dental supported doctors are united by a common goal: delivering the highest quality dental care and patient experiences.

Early 2018, KKR became Heartland Dental’s new lead investor, With Ontario Teacher’s Pension Plan (OTTP) remaining a minority investor.  KKR’s resources and partnership have opened up many new opportunities to further advance the company’s growth. With annual revenues exceeding $1 billion, we continue to expand our profitability and nationwide footprint. Growth is derived from same-office growth, new office development and new affiliations.  

This individual will work independently, but also as part of a dynamic team within the Revenue Cycle Management Department to meet company goals. To give you an idea of team structure, this individual will report to the Data Review Supervisor.

Below is an overview of the duties and responsibilities you would take on in this role:

• Systematically detect, investigate, and address data discrepancies and trends that require deeper review and may indicate larger systemic issues.
• Use analytical tools and techniques to identify patterns and determine the root cause of issues.
• Monitor and analyze data reports to detect recurring patterns in the data that point to larger issues with the first-pass success of claims.
• Prepare and present findings to relevant stakeholders, providing actionable insights to improve processes.
• Collaborate cross functionally with other departments to ensure data accuracy and integrity.
• The position will have access to minimum PHI necessary for performing job-related functions; regular HIPAA training, aligning with the specific role and responsibilities, will be required; and the individual will need to protect PHI and maintain data safeguards.
• Other projects as assigned

Minimum Requirements:

• Three or more years of experience in data analysis or a related field.
• Practical knowledge of consumer financing, dental or medical insurance and/or accounts receivable.
• Solid understanding of how to reallocate payments to procedures.
• Strong computer skills, including experience with Microsoft Word, Outlook, Excel, and PowerPoint.
• Strong organizational skills, accuracy, and attention to detail combined with excellent analytical abilities and a solutions-oriented mindset.
• Ability to handle sensitive material confidentially.
• Strong written and verbal communication skills, with the ability to provide explanations and interpretations within area of expertise.
• Ability to work independently, manage multiple tasks, and navigate complex projects with varying products and benefit levels.

Desirable Qualifications:

• Experience with insurance billing and/or collecting past due balances, preferably in a healthcare setting.
• Knowledge of a variety of hospital, physician, and/or dental billing systems.
• Knowledge of a variety of insurance online systems as well as online status/eligibility inquiry sites.
• Experience in Dental, Hospital, or Physician Billing and Collections.

Physical Requirements:

• Ability to perform essential duties satisfactorily with or without reasonable accommodation. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties of the position
• Prolonged periods sitting at a desk and working on a computer
• Must be able to lift up to 15 pounds at times

We put our people first at Heartland Dental, and that shows in our generous benefits package.

Company retains the sole discretion to change the duties of the position at any time.

We provide all employees and applicants for employment the protections of federal, state, and local laws affording equal opportunity in employment.