Product Specialist will assist in the exchange of product if needed and communicate with account throughout the entire process until completed, Work closely with new product development teams to plan and execute design validation strategy, Work closely with marketing and executive management to identify clinical study opportunities and priorities, Develop/approve/edit protocols, case report forms, and statistical plans, Ensure appropriate regulatory controls (site and patient) in place for studies and design validations, Monitor data collection to ensure timely completion of all studies and design validations, Lead clinical risk assessment for adverse events, participate in decision on field corrective actions. Notify auxiliary staff of emergency, Receive calls for office staff. Able to direct and lead others to produce desired results. Problem Solving: Demonstrated problem solving and organization skills. To work for and with a company that promotes advancement and learning. Verify accuracy of mailing slips with cases. Does not discuss other staff members, organizational policy and procedure, personal problems or a medical or dental condition in public areas. Detailed organizational ability with groups, projects, and assignments. Although dental assistants seldom work with patients unsupervised, they still must be knowledgeable about dental medicine to be able to anticipate the sequence of tasks in complex dental procedures. Familiarity with CDT and ICD codes will be advantageous. Experienced in ICD-10 coding, electronic health records, medical billing, and other administrative tasks. Maintain Hazardous Communication Policy Manuals. Interactions/Communications: Exchanges and interprets nonroutine information and/or collaboration of work. Makes every effort to appropriately and progressively inform members/patients waiting for care of the reason(s) for any delay and the prospects for when they can expect to be treated. sales, service, marketing, IT, etc.) Scheduling (work, meetings, appointments). Documented patient data and medical records, and performed routine medical record audit to comply with insurance company requirements. Core Qualifications include: Good communication with patients, billing department and staff regarding benefits information, Resolution of patient/payer issues, HIPAA Compliance, Healthcare Reimbursement, CCX, Medicare, Private and Secondary Insurance, Daily transmission of electronic claims and follow-up of rejected claims including correction of ICD9, ICD10, HCPCS, modifier, or other claim reject issues. Provided help in training all new employees on correct claim submission and using of software systems. Performs other duties as requested, Two (2) years of experience as a dental technician, Analyze and investigate dental claims in accordance with plan provisions and state & federal regulations, Accurately make decisions in a timely and effective manner, Interpret dental x-rays and anatomy, clinical narratives, office notes, contract provisions and claim procedures, Manage time to ensure compliance with our service timing, quality and production goals, Associates degree or equivalent and 2+ years related work experience (financial services, insurance industry, claims processing, or dental insurance experience preferred), Ability to use basic math skills to determine claim payment, Ability to maintain a high degree of accuracy and pay strict attention to detail, Work independently with good time management skills as well as in a team environment, Good analytical, organizational, problem solving and quick decision making skills, Must have the ability to efficiently navigate and use multiple technology solutions, Prior claim paying, coding, customer service, and/or medical/dental industry experience preferred (however formal training will be provided), Identifies and reports on typical patterns of care, Acts as a liaison between consultants, providers, members and operational departments to resolve unusual problems and complex cases, Provides analysis and information to corporate appeals and grievances, Reports savings and assist in recommending procedural and policy changes to maintain or increase revenue, Requires BA/BS; dental assistant certificate; 2 years of experience; or any combination of education and experience, which would provide an equivalent background, Detailed knowledge of dental procedures, coding and contracts required, Dental assistant/hygenist certificate required, Bachelor's Degree or higher from an accredited university, Considerable knowledge/understanding of dental CAD/CAM technology, equipment, and materials, Considerable knowledge/understanding of dental implantology, including CBCT and surgical case planning, Considerable knowledge/understanding of Traditional C&B restorative techniques, Five years of key account sales, business development, Superior qualifying, demonstrating, follow up, closing, and customer support ability, Ability to be very creative and assist in strategic development to further penetrate market infrastructure, Ability to develop effective, professional presentations and confidently speak in front of small and large groups of lab technicians, dentists, and other dental professionals, Assists in all aspects of the Quality Improvement Programs including, but not limited to, Current and Clear Dental license; must have all the appropriate education to have and maintain a dental license (Hawaii, Florida, California,or Alaska), 5+ years clinical practice or related experience, * Would consider telecommute, if you do not reside in Santa Ana ***, Create and execute GP marketing plan, working closely with Sales, in order to drive case utilization, Recruit and onboard GP doctors to be trained to provide Invisalign treatment, Develop positioning/messaging of Align brand and products to GP Customers, and create channel communications which motivate trial and utilization, Lead commercialization of product pipeline, working closely with New Product Development (NPD) teams. Sorts and distributes lab coats, Performs other related duties as assigned or requested. Hoping to resume as a Medical Billing Specialist at Savior Medicals; coming with 5+ years of billing experience in a medical setting to provide effective and efficient data entry and invoicing services, as well as to expedite insurance claim payments. Seeking a role of increased responsibility and authority. Skills : Microsoft Office, Administrative Assistant, Administrative Support, Administrative Duties, Accounts Receivable, Medical Terminology, Account Reconciliation, Accounting, Bookkeeping, Insurance Verification, Insurance, Customer Service, Call Center, Collections, Data Entry. This includes but is not limited to Sales Leadership Team, Marketing, Operations, Technical and Customer Service, Troubleshoot and evaluate all product reliability issues in assigned territory. Errors seriously impact patient and coworker safety and impact financial operations of this and other departments, Provides positive and effective communication and customer service that supports departmental and hospital operations; contributes to the teamwork within departments and organizations, Decision making guided by general instruction and practices requiring interpretation. Improved the acceptance rate of commercial claims through well-researched appeals proving medical necessities. Prepares solutions. S/he will support UCS and UHN initiatives and Quality Affordability Programs as required in order to achieve the appropriate utilization and affordability goals of the C&S Health Plan and United Clinical Services/UHC. Responsible for all clinical aspects of dental policy, quality assurance, claim adjudication, grievance and appeal processes, product design, contractual provisions and professional communication. Reviewing and approving the daily balancing and closing reports of encounters processed. Scanned documentation and entered into the database. Develop and sustain positive working relationships with internal staff, Work with the Dental Director(s), Utilization Review and other areas to identify opportunities to improve the claims review process, and reduce the cycle time of payment claims and predeterminations, 3-5 years' of experience in a clinical setting, Associate Degree-Associate's degree in Dental Hygiene or Associate Applied Science (AAS) in Dental Hygiene, 1-3 years' experience in Utilization Management / Quality Assurance / Managed Care, Experience with reviewing and analyzing dental claims data, Working knowledge of pertinent regulatory and compliance guidelines and dental policies, Proficiency in utilizing PC applications accessed by Dental Review, Ability to multi-task and perform in a fast paced and often intense environment, Ability to analyze data, measure outcomes, and develop action plans, Ability to be a team player who possesses strong analytical and organizational skills. *LI-NI1, Highly motivated individual with proven ability to meet challenging goals/targets, Excellent verbal and written communication skills with the confidence and ability to negotiate, Demonstrated ability to exercise initiative, independent judgment and be a self-starter, Must excel in a fast-paced business environment and be able to function with minimal supervision, Excellent interpersonal, organizational and prioritization skills, Valid driving license and reliable vehicle, Requires BA/BS; 5 years in progressively complex customer service environment; or any combination of education and experience, which would provide an equivalent background, Prior Dental experience or knowledge is preferred but not required, Preferred bilingual in Spanish but not required, Process and manage enrollments, aging, credit card processing and customer calls for individuals utilizing the Dental Insurance plans, Interact with customers on enrollment, billing questions and discrepanciesEducate customers regarding enrollments, receiving invoices and remitting payments, Monitor outstanding balances and take appropriate actions to ensure clients pay billProcess refunds and adjustments, Review for quality assurance and audit billing activities, Assist Supervisor on Projects and as a SME(Subject Matter Expert) as assigned, Ability to navigate all aspects of computer issues and access requests, Ability to multi-task, this includes ability to understand the healthcare industry, Ability to remain focused and productive each day, Manage Utilization Review and Prior Authorization Programs, Provide clinical support to the Fraud & Abuse and Payment Integrity Programs, Serve as the primary clinical liaison to external UR vendors, Oversee internal and external dental consultants and related staff, including training and development and Inter-rater Reliability, Identify providers with aberrant utilization patterns and support the Fraud/Abuse investigation process including auditing providers, generating reports, correspondence and provider outreach and remediation, Develop policies and procedures related to Utilization Review, Prior Authorization and Fraud/Abuse, Counsel participating and non-participating dentists with aberrant utilization patterns, Interface with external entities including UR Vendors, OptumInsight, regulatory agencies as required to support the UR, PA and FWA programs, Respond to RFPs related to UR, PA, FWA and the clinical aspects of payment integrity, Active dental license in at least one state, Comprehensive knowledge of Utilization Review, Strong PC skills including PowerPoint, Excel and Access, Responsible for achieving territory quota, new product budget and increasing sales within our top accounts, Develops new prospects and interacts with existing customers directly or in collaboration with dealers to sell the division’s products and/or services, Develops and implements a sales business plan for the territory in collaboration with marketing and other partners, Coordinates and conducts meetings and product training sessions with a variety of audiences to build product demand, Processes customer orders and provides account service to assigned and prospective customers, Inputs all call and sales activity into Seibel and utilizes that information to target high opportunities daily, Evolve strategic vision and prioritization for the portfolio of products critical to GB’s continued financial success, Identify and assess opportunities for new products or modification of existing products in light of market trends and customers’ needs, Provide key input into various decisions affecting products specifically designed for GB, Once implemented, analyze trends (product and competitive) to recommend strategies for ongoing product management, Lead and drive feasibility studies and concepts, evaluating the overall value they can deliver as a basis for prioritization of future product development projects, Lead, drive or sponsor development of all product initiatives within the given portfolio ensuring that all product development initiatives are met within cost and time deadlines, Accountable for the outcome of successful development within the product portfolio, Cultivate both internal and external relationships to evolve the GB product shelf, Manage of select number of third party vendors, Provide product information and assistance to business partners and various stakeholders to help them understand the products and services offered, Represent Sun Life on associated industry committees, as applicable, Design and Implement continuous improvement to the product development process that strives to improve partner engagement and reduce time/cost of launching solutions, Refine the new idea evaluation process such that there is an ongoing inventory of viable new product ideas to draw from, Ensure product solutions remain competitive, meet ongoing sales and profitability goals, and abide by the appropriate regulatory framework, Provide technical assistance regarding its end use indications to Dental Labs and/or providers via face to face, phone and remote online sessions, Resolve customer issues and inquiries promptly with high customer satisfaction, Assist customers with use of CAD/CAM design softwares, including installation and updates via remote logins, Create training modules for sales force training and development, Evaluate new technical products at the request of research and development, Provide input for the development of instructions for use for new products, Develop and contribute to the development of technical support materials for use by customers and employees, Provide machining support for proper manufacturing using dental mills, Educate and give technical support to customers on post-processing of RPD frames and/or other end-uses in the dental field, Make recommendations for scanning and design cases for customers and internal R&D, Perform quality control to assess fit on scan and design cases, making adjustments when necessary, Manage a controlled workflow ensuring service and prompt case delivery, Provide in-house and in-field training which may include seminars, lectures, demonstrations, clinics, trade shows and meetings at the request of the department manager, Provide technical advice and support to internal departments (Sales, Customer Service, and Education department), Conduct either remote (phone, net viewer) or on-site troubleshooting and diagnostic support to customers, Maintain expert level proficiency in CAD (3Shape Dental Systems preferred, but other CAD software experience considered), CAM, design and milling, Maintain excellent and accurate communications with the appropriate staff, Maintain quality logs and records as required by the Quality Management System, 5+ years of relevant experience as a Certified Dental Technician, Extensive knowledge of dental technology/terminology, Working knowledge of digital CAD/CAM process (particularly with dental design softwares 3Shape, Exocad, and/or Dentalwings) and requirements for dental applications, Understanding of RPD manufacturing via conventional techniques while milling/printing experience is a plus, Comprehensive knowledge of dental anatomy and dental occlusion, Experience with partials, dental restorations, metal and polymer framework, ceramics, implants, implant bridges, custom abutments, and full contour crown and bridge applications, Understanding of design requirements for dental materials, particularly acrylics, titanium, zirconia, metals, and various polymers, Strong IT background with CAD/CAM experience required (minimum 2 years dental lab experience), Excellent IT/PC skills, and have the ability to communicate advanced topics to users with very different backgrounds, Good interpersonal communication skills with the ability to work independently and in a small team environment, Must be detail oriented and have excellent problem-solving and analytical abilities with a certain degree of creativity and latitude, Electrical / Electronic and mechanical related work experience preferred, A strong understanding and competency with Windows and equipment operating software, maintaining and diagnosing electronic components, pneumatic and hydraulic systems, precision mechanical parts etc, Basic troubleshooting skills; ability to identify common hardware, software and design errors relevant to equipment, Fulfills administrative and teaching responsibilities for General (dental) Practice Residency or Oral and Maxillofacial Surgery Training Program to achieve the educational goal of the program, Performs as a Trauma Team Member in Oral and Maxillofacial Surgery for a Level I Trauma Center, Provides trauma and other on-call responsibilities consistent with the needs of an acute care hospital, Performs specialty diagnostic, therapeutic and consultative procedures for patients presenting for care in the Oral and Maxillofacial Surgery Outpatient Clinic; problems may include orofacial deformities, injuries or pathologic conditions of the jaws and associated structure, Maintains clinical privileges at both Harbor UCLA Medical Center and Martin Luther King Outpatient Care to ensure comprehensive dental care of the medically compromised patient, Performs public health dental services detecting and measuring the incidence and prevalence of oral health problems with emphasis on diagnosing, preventing, intercepting and controlling oral health diseases, Performs complex endodontics, including root canal therapy on the anterior and posterior teeth of both children and adults, stressing the more difficult posterior therapy and apicoectomy or root excisions along with retrofillings, Performs oral surgery, including removal of impacted teeth, torus mandibularis and torus palatinus, treats jaw fractures and removal of pre-malignant lesions, Performs advanced periodontic procedures, including minor orthodontic treatment, treats traumatic dental injuries and children with special medical or psychological problems such as heart disease, cerebral palsy, epilepsy and physical, mental, and emotional handicap, Performs complex procedures for the treatment of diseases and abnormalities of the periodontal structures of the jaw, Performs complex prosthodontic procedures, including construction of obtruators for cleft palates and prosthodontic appliances to replace missing structures and treats unusual and difficult denture cases, Performs comprehensive orthodontic services. 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