Pacific Dental Services
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ROC Product Analyst
at Pacific Dental Services
- Requisition ID
- Revenue Operations
- Location : External Name
- National Support Center
The Analyst, ROC Product is responsible for supporting the ROC team through obtaining, analyzing and communicating information that provides insight in the development of new products. The incumbent will be instrumental in the execution of product strategy with data driven and customer oriented focus. The incumbent will have internal and external client interactions to obtain validation and input into current development initiatives. The incumbent will create insights that drive the direction of the company.
- Identifying product opportunities, understanding experiment performance, and defining metrics for the business.
- Collaborate with internal and external stakeholders to gather requirements and map, structure, document, and validate technical requirements for new or enhanced ROC products.
- Research, document, and disseminate information of product industry and competitor trends, features, and news.
- Create documentation including process diagrams, use cases, business, functional, and non-functional requirements; developing use cases and functional requirements for features development.
- Analyze and audit claims submitted by the billers to identify inconsistencies.
- Ensure all claims submitted meet the consistency and quality standards of the company.
- Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.
- Perform daily activities of auditing patient claims billed to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.
- Analyze and communicate key insights for existing projects and act as a thought leader and subject matter expert for specific business problems.
- Monitor key performance metrics and understand root causes of change.
- Report weekly to Sr. Manager of Billing Operations detailing accomplishments, areas for improvement, clear performance goals, and effectiveness of existing processes and systems.
- Other duties as assigned by management.
- Bachelor's Degree in Business Management or a related field. In lieu of degree, +4 years of experience is required or the equivalent combination of education and experience.
- 4-6 years of related experience in product analysis, dental or medical billing operations.
- Knowledge of QSI software applications.
- Experience in a multi-regional healthcare, retail, or dental company.
- Ability to read and interpret EOBs (Explanation of Benefits).
- Prior customer service experience.
Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status.