What are the responsibilities and job description for the Dental Insurance Coordinator position at ProSmile?
POSITION SUMMARY:
The Insurance Collections Coordinator is responsible for reviewing the insurance accounts receivable report and reviewing in detail what treatment and service dates are outstanding.
ESSENTIAL FUNCTIONS:
Process Insurance Claims:
- Enter claims information into database systems.
- Prepare insurance claim forms or related documents and review them for completeness.
- Post or attach information to claim file.
- Transmit claims for payment or further investigation.
- Organize or work with detailed reports and records, using computers to enter, access, search or retrieve data.
- Close out claims or resubmit as necessary, and process in a timely manner and meeting filing deadlines and limits.
Process Collections:
- Verify insurance accounts in patient's history, including demographic information.
- Verify dates of service and payments received.
- Review and verify overdue accounts and track treatment and service dates that are outstanding.
- Contact offices, insurance companies, and providers to obtain missing insurance information and follow up on outstanding insurance claims.
Plan Administration:
- Create, update and input insurance fee schedules into practice management system.
- Create, update and input insurance plan rules into practice management system.
- Contact insurance companies annually or as needed to ensure fee schedules are up to date.
- Process and input patient insurance breakdowns into system.
- Answer any insurance related questions to patients, offices, or departments.
Dental Insurance Coordinator COMPETENCIES:
- Ability to analyze and interpret financial and insurance data.
- Ability to work follow policies and procedures accurately.
- Ability to analyze and solve problems while exercising a moderate degree of judgment.
- Ability to juggle competing demands and priorities and manage time well (both self and others) even when time is short.
- Dependability and outstanding organizational ability, including managing both paper and digital files, with focused attention to detail and follow through.
- Excellent interpersonal skills, including the ability to communicate clearly both verbally and in writing, and maintain a customer-oriented attitude during all interactions, including phone and in person.
- Must be proficient in Microsoft Office and must have experience using websites or software applications to find, review, edit, and submit insurance claims.
REQUIRED AND PREFERRED QUALIFICATIONS:
- Minimum Education: High School diploma
- Required Experience: 2-4 years of healthcare insurance and billing experience, preferably in a dental group.
- Required Knowledge: A working knowledge of dental terminology and dental-related insurance practices and procedures.
SCHEDULING REQUIREMENTS
- Requires some flexibility in scheduling, such as the ability to work evenings and weekends.
